Compositions and methods of delivery of pharmacological agents

ABSTRACT

The present invention relates to a pharmaceutical composition comprising a pharmaceutical agent and a pharmaceutically acceptable carrier, which carrier comprises a protein, for example, human serum albumin and/or deferoxamine. The human serum albumin is present in an amount effective to reduce one or more side effects associated with administration of the pharmaceutical composition. The invention also provides methods for reducing one or more side effects of administration of the pharmaceutical composition, methods for inhibiting microbial growth and oxidation in the pharmaceutical composition, and methods for enhancing transport and binding of a pharmaceutical agent to a cell.

CROSS-REFERENCE TO RELATED PATENT APPLICATIONS

This patent application claims the benefit of U.S. Provisional PatentApplication No. 60/432,317 filed Dec. 9, 2002, U.S. Provisional PatentApplication No. 60/526,544 filed Dec. 3, 2003, U.S. Provisional PatentApplication No. 60/526,773 filed Dec. 4, 2003, and U.S. ProvisionalPatent Application No. 60/527,177 filed Dec. 5, 2003.

FIELD OF THE INVENTION

This invention pertains to pharmaceutical compositions comprisingpharmaceutically active agents for parenteral or other internal use,which have the effect of reducing certain undesirable side effects uponadministration when compared with available formulations of similardrugs.

BACKGROUND OF THE INVENTION

It is well recognized that many drugs for parenteral use, especiallythose administered intravenously, cause undesirable side effects such asvenous irritation, phlebitis, burning and pain on injection, venousthrombosis, extravasation, and other administration related sideeffects. Many of these drugs are insoluble in water, and are thusformulated with solubilizing agents, surfactants, solvents, and/oremulsifiers that are irritating, allergenic, or toxic when administeredto patients (see, e.g., Briggs et al., Anesthesis 37, 1099 (1982), andWaugh et al., Am. J. Hosp. Pharmacists, 48, 1520 (1991)). Often, thefree drug present in the formulation induces pain or irritation uponadministration. For example, phlebitis was observed in 50% of patientswho received peripheral vein administration of ifosfamide andvinorelbine as first-line chemotherapy for advanced non-small cell lungcarcinoma. (see, e.g., Vallejo et al., Am. J. Clin. Oncol., 19(6), 584-8(1996)). Moreover, vancomycin has been shown to induce side effects suchas phlebitis (see, e.g., Lopes Rocha et al., Braz. J. Infect. Dis.,6(4), 196-200 (2002)). The use of cisplatin, gemcitabine, and SU5416 inpatients with solid tumors has resulted in adverse events such as deepvenous thromboses and phlebitis (see, e.g., Kuenen et al., J. Clin.Oncol., 20(6), 1657-67 (2002)). In addition, propofol, an anestheticagent, can induce pain on injection, burning and vein irritation,particularly when administered as a lecithin-stabilized fat emulsion(see, e.g, Tan et al., Anathesia, 53, 468-76, (1998)). Other drugs thatexhibit administration-associated side effects include, for example,Taxol (paclitaxel) (see, e.g., package insert for Taxol I.V.), codarone(amiodarone hydrochloride) (see, e.g., package insert for CodaroneI.V.), the thyroid hormone T3 or liothyronine (commercially available asTriostat), thiotepa, bleomycin, and diagnostic radiocontrast agents.

Another problem associated with the manufacture of drugs for injection,particularly water insoluble drugs, is the assurance of sterility.Sterile manufacturing of drug emulsions/dispersions can be accomplishedby absolute sterilization of all the components before manufacture,followed by absolutely aseptic technique in all stages of manufacture.However, such methods are time consuming and expensive. In addition, theoxidation of drug formulations by exposure to air during manufacture orstorage can lead to, for example, reduced pH, drug degradation, anddiscoloration, thereby destabilizing the drug formulation and/orreducing shelf life.

To circumvent the problems associated with administration-related sideeffects of drug formulations, alternate formulations have beenattempted. With respect to propofol, for example, methods for reducingpropofol-induced pain include increasing the fat content of the solvent(e.g., long chain triglycerides (LCT)), premedication, pretreatment withnon-steroidal drugs, local anaesthetics, opioids, the addition oflidocaine, the addition of cyclodextrin, and microfiltration (see, e.g.,Mayer et al., Anaesthesist, 45(11), 1082-4 (1996), Davies, et al.Anaesthesia, 57, 557-61 (2002), Doenicke, et al., Anaesth. Analg., 82,472-4 (1996), Larsen et al., Anaesthesitis 50, 842-5 (2001), Lilley etal., Anaesthesia, 51, 815-8 (1996), Bielen et al., Anesth. Analg.,82(5), 920-4 (1996), and Knibbe et al., Br. J. Clin. Pharmacol., 47(6),653-60 (1999)). These formulations, however, induce other side effects(e.g., cardiovascular complications), or cause destabilization ofpropofol emulsions.

To overcome the problem of bacterial contamination, propofolformulations have been developed with antibacterial agents, such as anEDTA equivalent (e.g., edetate), pentetate, or sulfite-containingagents, or they have been have been formulated with a lower pH (see,e.g., U.S. Pat. Nos. 5,714,520, 5,731,355, 5,731,356, 6,028,108,6,100,302, 6,147,122, 6,177,477, 6,399,087, 6,469,069, and InternationalPatent Application No. WO 99/39696). Since edetate and pentetate aremetal ion chelators, however, they have the potential to be dangerous byscavenging the essential metal ions from the body system. Moreover, theaddition of sulphites to drug formulations presents potential adverseeffects to the pediatric population and for those in the generalpopulation who are allergic to sulphur.

Thus, there remains a need for a composition and method that reduce oreliminate the side effects associated with the parenteral or in vivoadministration of drugs. There also is a need for a pharmaceuticalcomposition that is sterile, and methods of preparing such acomposition. In addition, there is a need for a pharmaceuticalcomposition and method that reduce or eliminate oxidation ofpharmaceutical formulations to prevent drug destabilization.

The invention provides such compositions and methods. These and otheradvantages of the invention, as well as additional inventive features,will be apparent from the description of the invention provided herein.

BRIEF SUMMARY OF THE INVENTION

The invention provides various embodiments of pharmaceuticalcompositions. One, some, or all of the properties of the variousembodiments can be found in different embodiments of the invention andstill fall within the scope of the appended claims.

The invention provides a pharmaceutical composition comprising apharmaceutical agent and a pharmaceutically acceptable carrier, whereinthe pharmaceutically acceptable carrier comprises a protein, such asalbumin, more preferably human serum albumin, in an amount effective toreduce one or more side effects of administration of the pharmaceuticalcomposition into a human, and wherein the pharmaceutically acceptablecarrier comprises deferoxamine in an amount effective to inhibitmicrobial growth in the pharmaceutical composition. The invention alsoprovides a pharmaceutical composition comprising a pharmaceutical agentand a pharmaceutically acceptable carrier, wherein the pharmaceuticallyacceptable carrier comprises a protein, such as albumin, in an amounteffective to reduce one or more side effects of administration of thepharmaceutical composition into a human, and wherein thepharmaceutically acceptable carrier comprises deferoxamine in an amounteffective to inhibit oxidation in the pharmaceutical composition.

The invention provides a method for reducing one or more side effectsassociated with administration of a pharmaceutical composition to ahuman comprising (a) administering to a human a pharmaceuticalcomposition comprising a pharmaceutical agent and a pharmaceuticallyacceptable carrier, wherein the pharmaceutically acceptable carriercomprises albumin and deferoxamine. Also provided are methods forinhibiting microbial growth, or for inhibiting oxidation, or forinhibiting microbial growth and oxidation in a pharmaceuticalcomposition. These methods comprise preparing a pharmaceuticalcomposition comprising a pharmaceutical agent and a pharmaceuticallyacceptable carrier, wherein the pharmaceutically acceptable carriercomprises deferoxamine in an amount effective for inhibiting microbialgrowth or in an amount effective for inhibiting oxidation in thepharmaceutical composition.

The invention also provides a method for enhancing transport of apharmaceutical agent to the site of an infirmity, which method comprisesadministering to a human a pharmaceutical composition comprising apharmaceutical agent and a pharmaceutically acceptable carrier, whereinthe pharmaceutically acceptable carrier comprises albumin, and whereinthe ratio of albumin to pharmaceutical agent in the pharmaceuticalcomposition is about 18:1 or less. The invention further provides amethod for enhancing binding of a pharmaceutical agent to a cell invitro or in vivo, which method comprises administering to said cell invitro or in vivo a pharmaceutical composition comprising apharmaceutical agent and a pharmaceutically acceptable carrier, whereinthe pharmaceutically acceptable carrier comprises albumin, and whereinthe ratio of albumin to pharmaceutical agent in the pharmaceuticalcomposition is about 18:1 or less.

The invention also provides a pharmaceutical composition comprising apharmaceutical agent and a pharmaceutically acceptable carrier, whereinthe pharmaceutically acceptable carrier comprises albumin in an amounteffective to increase transport of the drug to the site of infirmity ina human, and wherein the ratio of albumin to pharmaceutical agent isabout 18:1 or less.

The invention further provides a method for increasing the transport ofa pharmaceutical agent to a cell in vitro or in vivo by combining saidagent with a protein, wherein said protein binds a specific cell-surfacereceptor on said cell, wherein said binding of theprotein-pharmaceutical agent combination with the said receptor causesthe transport to occur, and wherein the ratio of protein topharmaceutical agent is about 18:1 or less.

DETAILED DESCRIPTION OF THE INVENTION

The invention provides a pharmaceutical composition comprising apharmaceutical agent and a pharmaceutically acceptable carrier, whereinthe pharmaceutically acceptable carrier comprises a protein such asalbumin, preferably human serum albumin, in an amount effective toreduce one or more side effects of administration of the pharmaceuticalcomposition to a human, and wherein the pharmaceutically acceptablecarrier comprises deferoxamine in an amount effective to inhibitmicrobial growth in the pharmaceutical composition. The invention alsoprovides a pharmaceutical composition comprising a pharmaceutical agentand a pharmaceutically acceptable carrier, wherein the pharmaceuticallyacceptable carrier comprises a protein such as albumin in an amounteffective to reduce one or more side effects of administration of thepharmaceutical composition to a human, and wherein the pharmaceuticallyacceptable carrier comprises deferoxamine in an amount effective toinhibit oxidation in the pharmaceutical composition.

Any suitable pharmaceutical agent can be used in the inventivepharmaceutical composition. Suitable pharmaceutical agents include, butare not limited to, anticancer agents or antineoplastics,antimicrotubule agents, immunosuppressive agents, anesthetics, hormones,agents for use in cardiovascular disorders, antiarrythmics, antibiotics,antifungals, antihypertensives, antiasthmatics, analgesics,anti-inflammatory agents, anti-arthritic agents, and vasoactive agents.The invention is useful with many other drug classes as well. Morespecifically, suitable pharmaceutical agents include, but are notlimited to, taxanes, (e.g., Taxol® (paclitaxel), and Taxotere™(docetaxel)), epothilones, camptothecin, colchicine, amiodarone, thyroidhormones, vasoactive peptides (e.g., vasoactive intestinal peptide),amphotericin, corticosteroids, propofol, melatonin, cyclosporine,rapamycin (sirolimus), tacrolimus, mycophenolic acids, ifosfamide,vinorelbine, vancomycin, gemcitabine, SU5416, thiotepa, bleomycin,diagnostic radiocontrast agents, and derivatives thereof. Other drugsthat are useful in the inventive composition are described in, forexample, U.S. Pat. No. 5,916,596 and co-pending U.S. patent applicationSer. No. 09/446,783. Preferably, the pharmaceutical agent is propofol,paclitaxel, or docetaxel. More preferably, the pharmaceutical agent ispropofol or paclitaxel. Most preferably, the pharmaceutical agent ispropofol.

Taxol® (paclitaxel) (Bristol-Myers Squibb) is active against carcinomasof the ovary, breast, lung, esophagus and head and neck. Taxol, however,has been shown to induce toxicities associated with administration, aswell significant acute and cumulative toxicity, such asmyelosuppression, neutropenic fever, anaphylactic reaction, andperipheral neuropathy. Because paclitaxel is poorly soluble in water,cremophor typically is used as a solvent, requiring large infusionvolumes and special tubing and filters. Cremophor is associated withside effects that can be severe, including anaphylaxis and otherhypersensitivity reactions that can require pretreatment withcorticosteroids, antihistamines, and H₂ blockers (see, e.g., Gelderblomet al., Eur. J. of Cancer, 37, 1590-1598, (2001)). Taxotere™ (docetaxel)is used in treatment of anthracycline-resistant breast cancer, but alsohas previously been shown to induce side effects of hypersensitivity andfluid retention that can be severe. Epothilone (and derivatives thereof)also typically is administered in cremophor, and has been shown toinduce severe neutropenia, hypersensitivity, and neuropathy.

Propofol (2,6-diisopropylphenol) is a hydrophobic, water-insoluble oil,which is widely used as an intravenous anesthetic agent to induce andmaintain general anesthesia and sedation of humans and animals. Propofoltypically is administered directly into the bloodstream and crosses theblood-brain barrier. Pharmaceutical compositions comprising propofolmust have sufficient lipid solubility to cross this barrier and depressthe relevant mechanisms of the brain. Propofol has a maximum solubilityin water of 1.0+/−0.02 μM at 22.5° C. (see, e.g., Tonner et al.,Anesthesiology, 77, 926-931 (1992)). As such, propofol is generallyformulated as an emulsion containing solubilizing agents, surfactants,solvents, or as an oil-in-water emulsion (see, e.g., U.S. Pat. Nos.6,150,423, 6,326, 406, and 6,362,234). In addition to the activepharmaceutical agent, the compositions of the present invention includepharmaceutical carriers, or excipients. The choice of carrier is notnecessarily critical, and any of the carriers known in the art can beused in the composition. The choice of carrier is preferably determined,in part, by the particular site to which the pharmaceutical compositionis to be administered and the particular method used to administer thepharmaceutical composition. Preferably, the pharmaceutically acceptablecarrier comprises proteins. Any suitable protein can be used. Examplesof suitable proteins include, but are not limited to albumin,immunoglobulins including IgA, lipoproteins, apolipoprotein B,beta-2-macroglobulin, thyroglobulin and the like. Most preferably, thepharmaceutically acceptable carrier comprises albumin, most preferablyhuman serum albumin. Proteins, including albumin, suitable for theinvention may be natural in origin or synthetically prepared.

Human serum albumin (HSA) is a highly soluble globular protein of M_(r)65K and consists of 585 amino acids. HSA is the most abundant protein inthe plasma and accounts for 70-80% of the colloid osmotic pressure ofhuman plasma. The amino acid sequence of HSA contains a total of 17disulphide bridges, one free thiol (Cys 34), and a single tryptophan(Trp 214). Intravenous use of HSA solution has been indicated for theprevention and treatment of hypovolumic shock (see, e.g., Tullis, JAMA,237, 355-360, 460-463, (1977)) and Houser et al., Surgery, Gynecologyand Obstetrics, 150, 811-816 (1980)) and in conjunction with exchangetransfusion in the treatment of neonatal hyperbilirubinemia (see, e.g.,Finlayson, Seminars in Thrombosis and Hemostasis, 6, 85-120, (1980)).

Human serum albumin (HSA) has multiple hydrophobic binding sites (atotal of eight for fatty acids, an endogenous ligand of HSA) and binds adiverse set of drugs, especially neutral and negatively chargedhydrophobic compounds (Goodman et al., The Pharmacological Basis ofTherapeutics, 9^(th) ed, McGraw-Hill New York (1996)). Two high affinitybinding sites have been proposed in subdomains IIA and IIIA of HSA,which are highly elongated hydrophobic pockets with charged lysine andarginine residues near the surface which function as attachment pointsfor polar ligand features (see, e.g., Fehske et al., Biochem. Pharmcol.,30, 687-92 (1981), Vorum, Dan. Med. Bull., 46, 379-99 (1999),Kragh-Hansen, Dan. Med. Bull., 1441, 131-40 (1990), Curry et al., Nat.Struct. Biol., 5, 827-35 (1998), Sugio et al., Protein. Eng., 12, 439-46(1999), He et al., Nature, 358, 209-15 (1992), and Carter et al., Adv.Protein. Chem., 45, 153-203 (1994)). Paclitaxel and propofol have beenshown to bind HSA (see, e.g., Paal et al., Eur. J. Biochem., 268(7),2187-91 (2001), Purcell et al., Biochim. Biophys. Acta, 1478(1), 61-8(2000), Altmayer et al., Arzneimittelforschung, 45, 1053-6 (1995), andGarrido et al., Rev. Esp. Anestestiol. Reanim., 41, 308-12 (1994)). Inaddition, docetaxel has been shown to bind to human plasma proteins(see, e.g., Urien et al., Invest. New Drugs, 14(2), 147-51 (1996)).Thus, while not wishing to be bound to any particular theory, it isbelieved that the inclusion of proteins such as albumin in the inventivepharmaceutical compositions results in a reduction in side effectsassociated with administration of the pharmaceutical composition that isdue, at least in part, to the binding of human serum albumin to any freedrug that is present in the composition.

The amount of albumin included in the pharmaceutical composition of thepresent invention will vary depending on the pharmaceutical activeagent, other excipients, and the route and site of intendedadministration. Desirably, the amount of albumin included in thecomposition is an amount effective to reduce one or more side effectsthe active pharmaceutical agent due to the of administration of theinventive pharmaceutical composition to a human. Typically, thepharmaceutical composition is prepared in liquid form, and the albuminis then added in solution. Preferably, the pharmaceutical composition,in liquid form, comprises from about 0.1% to about 25% by weight (e.g.about 0.5% by weight, about 5% by weight, about 10% by weight, about 15%by weight, or about 20% by weight) of albumin. Most preferably, thepharmaceutical composition, in liquid form, comprises about 0.5% toabout 5% by weight of albumin. The pharmaceutical composition can bedehydrated, for example, by lyophilization, spray-drying, fluidized-beddrying, wet granulation, and other suitable methods known in the art.When the composition is prepared in solid form, such as by wetgranulation, fluidized-bed drying, and other methods known to thoseskilled in the art, the albumin preferably is applied to the activepharmaceutical agent, and other excipients if present, as a solution.The HSA solution preferably is from about 0.1% to about 25% by weight(about 0.5% by weight, about 5% by weight, about 10% by weight, about15% by weight, or about 20% by weight) of albumin.

In addition to albumin, the compositions of the present inventionpreferably comprise deferoxamine. Deferoxamine is a natural productisolated from Streptomyces pilosus, and is capable of forming ironcomplexes. Deferoxamine mesylate for injection USP, for example, isapproved by the Food and Drug Administration as an iron-chelating agentand is available for intramuscular, subcutaneous, and intravenousadministration. Deferoxamine mesylate USP is a white to off-whitepowder. It is freely soluble in water and its molecular weight is656.79. The chemical name for deferoxamine mesylate isN-[5-[3-[(5-aminopentyl)-hydroxycarbamoyl]-propion-amido]pentyl]-3[[5-((N-hydroxyacetamido)pentyl]-carbamoyl]propionohydroxamicacid monomethanesulfonate (salt), and its structural formula isC₂₅H₄₈N₆O₈.CH₃SO₃H. As described in the Examples, deferoxamine, oranalogs, derivatives, or salts (e.g., mesylate salts) thereof inhibitsmicrobial growth and oxidation in the pharmaceutical composition, and itis believed to bind to free drug in the composition. Deferoxamine alsohas been shown to bind to phenolic compounds (see, e.g., Juven et al.,J. Appl. Bacteriol., 76(6), 626-31 (1994)). Paclitaxel, docetaxel,propofol, and the like, are either phenolic like or have phenolic orphenyl substituents. Therefore, it is believed that deferoxamine canbind to or reduce the amount of free drug in the inventivepharmaceutical composition, thereby also reducing or alleviatingirritation or pain upon injection.

The amount of deferoxamine, or its preferred salt, i.e., a mesylate saltof deferoxamine, included in the composition will depend on the activepharmaceutical agent and other excipients. Desirably, the amount ofdeferoxamine, its salts, and analogs thereof in the composition is anamount effective to inhibit microbial growth and/or inhibit oxidation.As described above, typically the pharmaceutical composition is preparedin liquid form, and deferoxamine, it salts, and analogs thereof, is thenadded in solution. Preferably, the pharmaceutical composition, in liquidform, comprises from about 0.0001% to about 0.5% by weight (e.g., about0.005% by weight, about 0.1%, or about 0.25% by weight) of deferoxamine,its salts, or its analogs. More preferably, the composition, in liquidform, comprises like amounts of the preferred deferoxamine salt,deferoxamine mesylate. Most preferably, the pharmaceutical composition,in liquid form, comprises about 0.1% by weight of deferoxamine mesylate.When the composition is prepared in solid form, as described above, suchas by wet granulation, fluidized-bed drying, and other methods known tothose skilled in the art, deferoxamine mesylate preferably is applied tothe active pharmaceutical agent, and other excipients if present, as asolution. The deferoxamine mesylate solution preferably is from about0.0001% to about 0.5% by weight (e.g., about 0.005% by weight, about0.1%, or about 0.25% by weight) of deferoxamine.

In keeping with the invention, the pharmaceutical composition caninclude other agents, excipients, or stabilizers to improve propertiesof the composition. For example, to increase stability by increasing thenegative zeta potential of nanoparticles or nanodroplets, certainnegatively charged components may be added. Such negatively chargedcomponents include, but are not limited to bile salts of bile acidsconsisting of glycocholic acid, cholic acid, chenodeoxycholic acid,taurocholic acid, glycochenodeoxycholic acid, taurochenodeoxycholicacid, litocholic acid, ursodeoxycholic acid, dehydrocholic acid andothers; phospholipids including Lecithin (Egg yolk) based phospholipidswhich include the following phosphatidylcholines:palmitoyloleoylphosphatidylcholine,palmitoyllinoleoylphosphatidylcholine,stearoyllinoleoylphosphatidylcholine stearoyloleoylphosphatidylcholine,stearoylarachidoylphosphatidylcholine, anddipalmitoylphosphatidylcholine. Other phospholipids includingL-α-dimyristoylphosphatidylcholine (DMPC), dioleoylphosphatidylcholine(DOPC), distearyolphosphatidylcholine (DSPC), hydrogenated soyphosphatidylcholine (HSPC), D-α-phosphatidylcholine,β-acetyl-γ-O-hexadecyl, L-α-phosphatidylcholine, β-acetyl-γ-O-hexadecyl,DL-α-phosphatidylcholine, β-acetyl-γ-O-hexadecyl,L-α-phosphatidylcholine, β-acetyl-γ-O-octadecyl,L-α-phosphatidylcholine, β-arachidonoyl-γ-O-hexadecyl,L-α-phosphatidylcholine, β-acetyl-γ-O-(octadec-9-cis-enyl),D-α-phosphatidylcholine, β-arachidonoyl-γ-O-palmitoyl,3-sn-phosphatidylcholine, 2-arachidinoyl-1-stearoyl,L-α-phosphatidylcholine, β-arachidonoyl-γ-stearoyl,L-α-phosphatidylcholine, diarachidoyl, L-α-phosphatidylcholine,dibehenoyl, L-α-phosphatidylcholine,β-(cis-8,11,14-eicosatrienoyl)-γ-O-hexadecyl, L-α-phosphatidylcholine,β-oleoyl-γ-myristoyl, L-α-phosphatidylcholine,β-(pyren-1-yl)decanoyl-γ-palmitoyl,3-sn-phosphatidyl-N,N-dimethylethanolamine, 1,2-dipalmitoyl,L-α-phosphatidylethanolamine, diheptadecanoyl,3-sn-phosphatidylethanolamine, 1,2-dilauroyl,3-sn-phosphatidylethanolamine, 1,2-dimyristoyl,3-sn-phosphatidylethanolamine, 1,2-dioleoyl,3-sn-phosphatidylethanolamine, 1,2-dipalmitoyl,L-α-phosphatidylethanolamine, dipalmitoyl, L-α-phosphatidylethanolamine,dipalmitoyl, N-dansyl, L-α-phosphatidylethanolamine, dipalmitoyl,N,N-dimethyl, L-α-dimyristoylphosphatidylglycerol (sodium salt) (DMPG),dipalmitoylphosphatidylglycerol (sodium salt) (DPPG),distearoylphosphatidylglycerol (sodium salt) (DSPG),N-(carbonyl-methoxypolyethylene glycol2000)-1,2-distearoyl-sn-glycero-3-phosphoethanolamine sodium(MPEG-DSPE), L-α-phosphatidic acid, didecanoyl sodium salt,L-α-phosphatidic acid, diheptadecanoyl sodium salt, 3-sn-phosphatidicacid, 1,2-dimyristoyl sodium salt, L-α-phosphatidic acid, dioctanoylsodium salt, L-α-phosphatidic acid, dioleoyl sodium salt,L-α-phosphatidic acid, dipalmitoyl sodium salt,L-α-Phosphatidyl-DL-glycerol, dimyristoyl sodium salt,L-α-phosphatidyl-DL-glycerol, dioleoyl sodium salt,L-α-phosphatidyl-DL-glycerol, dipalmitoyl ammonium salt,L-α-phosphatidyl-DL-glycerol, distearoyl ammonium salt,L-α-phosphatidyl-DL-glycerol, β-oleoyl-γ-palmitoyl ammonium salt,L-α-phosphatidylinositol ammonium salt, L-α-phosphatidylinositol sodiumsalt, L-α-phosphatidyl-L-serine, dioleoyl sodium salt,L-α-phosphatidyl-L-serine, and dipalmitoyl sodium salt. Negativelycharged surfactants of emulsifiers are also suitable as additives, e.g.,sodium cholesteryl sulfate and the like.

The pharmaceutical agent (e.g., propofol) may be used alone or dissolvedin a water-immiscible solvent. A wide range of water-immiscible solventssuch as soybean, safflower, cottonseed, corn, sunflower, arachis,castor, or olive oil may be used. The preferred oil is a vegetable oil,wherein soybean oil is most preferred. Soybean oil may be used in arange of 1% to 10% by weight of the composition. Preferably soybean oilis present in the pharmaceutical composition in an amount of about 3% byweight.

The inventive pharmaceutical composition can be stabilized with apharmaceutically acceptable surfactant. The term “surfactants,” as usedherein, refers to surface active group(s) of amphiphile molecules.Surfactants can be anionic, cationic, nonionic, and zwitterionic. Anysuitable surfactant can be included in the inventive pharmaceuticalcomposition. Suitable surfactants include non-ionic surfactants such asphosphatides, polyoxyethylene sorbitan esters, and tocopherylpolyethylene glycol succinate. Preferable surfactants are egg lecithin,tween 80, and vitamin E-t d-α-tocopheryl polyethylene glycol-1000succinate (TPGS). For soybean oil containing formulations, egg lecithinis preferred and is no more than 1.2% by weight for a formulationcontaining 3% soybean oil, preferably at 1.1% by weight of thecomposition. For formulations without soybean oil, tween 80 or vitaminE-TPGS are the preferred surfactants. Typically, 0.1 to 1.5% by weightof tween 80 or 0.5 to 4% by weight of vitamin E-TPGS is suitable.Preferably, 1.5% by weight of tween 80 or 1% by weight of vitamin E-TPGSis used. Examples of other suitable surfactants are described in, forexample, Becher, Emulsions: Theory and Practice, Robert E. KriegerPublishing, Malabar, Fla. (1965).

There are a wide variety of suitable formulations of the inventivepharmaceutical composition (see, e.g., U.S. Pat. No. 5,916,596). Thefollowing formulations and methods are merely exemplary and are in noway limiting. Formulations suitable for oral administration can consistof (a) liquid solutions, such as an effective amount of the compounddissolved in diluents, such as water, saline, or orange juice, (b)capsules, sachets or tablets, each containing a predetermined amount ofthe active ingredient, as solids or granules, (c) suspensions in anappropriate liquid, and (d) suitable emulsions. Tablet forms can includeone or more of lactose, mannitol, corn starch, potato starch,microcrystalline cellulose, acacia, gelatin, colloidal silicon dioxide,croscarmellose sodium, talc, magnesium stearate, stearic acid, and otherexcipients, colorants, diluents, buffering agents, moistening agents,preservatives, flavoring agents, and pharmacologically compatibleexcipients. Lozenge forms can comprise the active ingredient in aflavor, usually sucrose and acacia or tragacanth, as well as pastillescomprising the active ingredient in an inert base, such as gelatin andglycerin, or sucrose and acacia, emulsions, gels, and the likecontaining, in addition to the active ingredient, such excipients as areknown in the art.

Formulations suitable for parenteral administration include aqueous andnon-aqueous, isotonic sterile injection solutions, which can containanti-oxidants, buffers, bacteriostats, and solutes that render theformulation isotonic with the blood of the intended recipient, andaqueous and non-aqueous sterile suspensions that can include suspendingagents, solubilizers, thickening agents, stabilizers, and preservatives.The formulations can be presented in unit-dose or multi-dose sealedcontainers, such as ampules and vials, and can be stored in afreeze-dried (lyophilized) condition requiring only the addition of thesterile liquid excipient, for example, water, for injections,immediately prior to use. Extemporaneous injection solutions andsuspensions can be prepared from sterile powders, granules, and tabletsof the kind previously described. Injectable formulations are preferred.

Formulations suitable for aerosol administration comprise the inventivepharmaceutical composition include aqueous and non-aqueous, isotonicsterile solutions, which can contain anti-oxidants, buffers,bacteriostats, and solutes, as well as aqueous and non-aqueous sterilesuspensions that can include suspending agents, solubilizers, thickeningagents, stabilizers, and preservatives, alone or in combination withother suitable components, which can be made into aerosol formulationsto be administered via inhalation. These aerosol formulations can beplaced into pressurized acceptable propellants, such asdichlorodifluoromethane, propane, nitrogen, and the like. They also canbe formulated as pharmaceuticals for non-pressured preparations, such asin a nebulizer or an atomizer.

Other suitable formulations are possible, for example, suppositories canbe prepared by use of a variety of bases such as emulsifying bases orwater-soluble bases. Formulations suitable for vaginal administrationcan be presented as pessaries, tampons, creams, gels, pastes, foams, orspray formulas containing, in addition to the active ingredient, suchcarriers as are known in the art to be appropriate.

In a preferred embodiment of the invention, the pharmaceuticalcomposition is formulated to have a pH range of 4.5 to 9.0, and morepreferably a pH of 5.0 to 8.0. The pharmaceutical composition can alsobe made to be isotonic with blood by the addition of a suitable tonicitymodifier, such as glycerol. Moreover, the pharmaceutically acceptablecarrier preferably also comprises pyrogen-free water or water forinjection, USP. Preferably, the inventive pharmaceutical composition isprepared as a sterile aqueous formulation, a nanoparticle, anoil-in-water emulsion, or a water-in-oil emulsion. Most preferably, thepharmaceutical composition is an oil-in-water emulsion.

For a pharmaceutical composition comprising propofol, in accordance withthe invention, an oil-in-water emulsion is prepared by dissolvingpropofol in a water-immiscible solvent alone, and preparing an aqueousphase containing albumin, deferoxamine, a surfactant, and otherwater-soluble ingredients, and mixing the oil with the aqueous phase.The crude emulsion is high pressure homogenized at pressures of 10,000to 25,000 psi and recirculated for 5 to 20 cycles to form an idealemulsion. The preferred pressure is 15,000 to 20,000 psi., and morepreferably 10,000 psi. The crude emulsion may be recirculated from 7 to15 cycles and is preferably recirculated at 15 cycles. Alternatively,discrete passes through a homogenizer may be used.

Preferably, the inventive pharmaceutical composition can have a particleor droplet size less than about 200 nanometers (nm). For example, in thecase of paclitaxel, docetaxel, rapamycin, cyclosporine, propofol andothers, the mean size of these dispersions is less than 200 nm.

The invention further provides a method for reducing one or more sideeffects associated with administration of a pharmaceutical compositionto a human. The method comprises administering to a human apharmaceutical composition comprising a pharmaceutical agent and apharmaceutically acceptable carrier, wherein the pharmaceuticallyacceptable carrier comprises albumin and deferoxamine. Descriptions ofthe pharmaceutical composition, pharmaceutical agent, andpharmaceutically acceptable carrier, and components thereof set forthabove in connection with the inventive pharmaceutical composition, alsoare applicable to those same aspects of the inventive method.

The dose of the inventive pharmaceutical composition administered to ahuman, in the context of the invention, will vary with the particularpharmaceutical composition, the method of administration, and theparticular site being treated. The dose should be sufficient to effect adesirable response, such as a therapeutic or prophylactic responseagainst a particular disease, or, when the pharmaceutical agent is ananaesthesia, such as propofol, an anesthetic response, within adesirable time frame.

While any suitable means of administering the pharmaceutical compositionto the human can be used within the context of the invention, preferablythe inventive pharmaceutical composition is administered to the humanvia intravenous administration, intra-arterial administration,intrapulmonary administration, oral administration, inhalation,intravesicular administration, intramuscular administration,intra-tracheal administration, subcutaneous administration, intraocularadministration, intrathecal administration, or transdermaladministration. For example, the inventive pharmaceutical compositioncan be administered by inhalation to treat conditions of the respiratorytract. There are minimal side-effects associated with the inhalation ofthe inventive pharmaceutical composition, as albumin is a naturalcomponent in the lining and secretions of the respiratory tract. Theinventive composition can be used to treat respiratory conditions suchas pulmonary fibrosis, broncheolitis obliterans, lung cancer,bronchoalveolar carcinoma, and the like.

The inventive method results in the reduction of one or more sideeffects associated with administration of a pharmaceutical compositionto a human. Such side effects include, for example, myelosuppression,neurotoxicity, hypersensitivity, inflammation, venous irritation,phlebitis, pain, skin irritation, and combinations thereof. These sideeffects, however, are merely exemplary, and other side effects, orcombination of side effects, associated with various pharmaceuticalagents can be reduced or avoided by the use of the novel compositionsand methods of the present invention.

The invention further provides a method for inhibiting microbial growthin a pharmaceutical composition. By “inhibiting microbial growth” ismeant either a complete elimination of microbes from the pharmaceuticalcomposition, or a reduction in the amount or rate of microbial growth inthe pharmaceutical composition. The method comprises preparing apharmaceutical composition comprising a pharmaceutical agent and apharmaceutically acceptable carrier, wherein the pharmaceuticallyacceptable carrier comprises deferoxamine, its salts, its analogs, andcombinations thereof, in an amount effective for inhibiting microbialgrowth in the pharmaceutical composition. In addition, the inventionprovides a method for inhibiting oxidation of a pharmaceuticalcomposition. This method comprises preparing a pharmaceuticalcomposition comprising a pharmaceutical agent and a pharmaceuticallyacceptable carrier, wherein the pharmaceutically acceptable carriercomprises deferoxamine, its salts, its analogs, and combinationsthereof, in an amount effective for inhibiting oxidation of thepharmaceutical composition. Descriptions of the pharmaceuticalcomposition, pharmaceutical agent, and pharmaceutically acceptablecarrier, and components thereof set forth above in connection with theinventive pharmaceutical composition, also are applicable to those sameaspects of the inventive method.

The amount of deferoxamine, or its preferred salt, a mesylate salt ofdeferoxamine, included in the composition will depend on the activepharmaceutical agent and other excipients. Desirably, the amount ofdeferoxamine, its salts, and analogs thereof in the composition is anamount effective to inhibit microbial growth and/or inhibit oxidation.As described above, typically, the pharmaceutical composition isprepared in liquid form, and deferoxamine, it salts, and analogsthereof, is then added in solution. Preferably, the pharmaceuticalcomposition, in liquid form, comprises from about 0.0001% to about 0.5%by weight (e.g., about 0.005% by weight, about 0.1%, or about 0.25% byweight) of deferoxamine, its salts, or its analogs. More preferably, thecomposition, in liquid form, comprises like amounts of the preferreddeferoxamine salt, deferoxamine mesylate. Most preferably, thepharmaceutical composition, in liquid form, comprises about 0.5% byweight of deferoxamine mesylate. When the composition is prepared insolid form, as described above, such as by wet granulation,fluidized-bed drying, and other methods known to those skilled in theart, deferoxamine mesylate preferably is applied to the activepharmaceutical agent, and other excipients if present, as a solution.The deferoxamine mesylate solution preferably is from about 0.0001% toabout 0.5% by weight (e.g., about 0.005% by weight, about 0.1%, or about0.25% by weight) of deferoxamine.

The invention also provides a method for enhancing transport of apharmaceutical agent to the site of an infirmity, which method comprisesadministering to a human a pharmaceutical composition comprising apharmaceutical agent and a pharmaceutically acceptable carrier, whereinthe pharmaceutically acceptable carrier comprises albumin, and whereinthe ratio of albumin to pharmaceutical agent in the pharmaceuticalcomposition is about 18:1 or less. The invention further provides amethod for enhancing binding of a pharmaceutical agent to a cell invitro or in vivo, which method comprises administering to said cell invitro or in vivo a pharmaceutical composition comprising apharmaceutical agent and a pharmaceutically acceptable carrier, whereinthe pharmaceutically acceptable carrier comprises albumin, and whereinthe ratio of albumin to pharmaceutical agent in the pharmaceuticalcomposition is about 18:1 or less. Descriptions of the pharmaceuticalcomposition, pharmaceutical agent, pharmaceutically acceptable carrier,administration routes, and components thereof set forth above inconnection with the inventive pharmaceutical composition and inventivemethod also are applicable to those same aspects of the transport andbinding methods.

In the methods for enhancing transport of a pharmaceutical agent to thesite of an infirmity or for enhancing binding of a pharmaceutical agentto a cell, the pharmaceutically acceptable carrier preferably comprisesalbumin, most preferably human serum albumin. Not to adhere to any oneparticular theory, it is believed that the ratio of protein, e.g., humanserum albumin, to pharmaceutical agent in the pharmaceutical compositionaffects the ability of the pharmaceutical agent to bind and transportthe pharmaceutical agent to a cell. In this regard, higher ratios ofprotein to pharmaceutical agent generally are associated with poor cellbinding and transport of the pharmaceutical agent, which possibly is theresult of competition for receptors at the cell surface. The ratio ofprotein, e.g., albumin, to active pharmaceutical agent must be such thata sufficient amount of pharmaceutical agent binds to, or is transportedby, the cell. Exemplary ranges for protein-drug preparations are proteinto drug ratios (w/w) of 0.01:1 to about 100:1. More preferably, theratios are in the range of 0.02:1 to about 40:1. While the ratio ofprotein to pharmaceutical agent will have to be optimized for differentprotein and pharmaceutical agent combinations, generally the ratio ofprotein, e.g., albumin, to pharmaceutical agent is about 18:1 or less(e.g., about 15:1, about 10:1, about 5:1, or about 3:1). Morepreferably, the ratio is about 0.2:1 to about 12:1. Most preferably, theratio is about 1:1 to about 9:1. Preferably, the formulation isessentially free of cremophor, and more preferably free of Cremophor EL®(BASF). Cremophor EL® is a non-ionic emulsifying agent that is apolyether of castor oil and ethylene oxide. As described above,cremophor typically is used as a solvent for paclitaxel, and isassociated with side effects that can be severe (see, e.g., Gelderblomet al., supra).

The pharmaceutical agent can be any suitable pharmaceutical agentdescribed herein (e.g., propofol, paclitaxel, or docetaxel). Inaddition, the pharmaceutical agent can be a nucleic acid sequence, mostpreferably a DNA sequence. In this regard, the inventive pharmaceuticalcomposition can be used to transport genes to a cell by way of areceptor mediated/caveolar/vescicular transport. In order to transportDNA sequences, such as genes or other genetic material, including butnot limited to plasmids or c-DNA, into a cell (e.g. an endothelial cellor a tumor cell), pharmaceutical compositions comprising albumin incombination with genetic material can be prepared. Since tumor cells andother cells in sites of inflammation have high uptake for proteins, thegenetic material is preferentially taken up into these cell types andmay be incorporated into the genetic material of the cell for a usefultherapeutic effect. The use of proteins, such as human serum albumin,serves as a non-viral vector for the delivery of genetic materialwithout the risk of virus-associated diseases or side effects. Forexample, a pharmaceutical composition comprising the nucleic acidsequence encoding β-galactosidase or green fluorescent protein (GFP) andalbumin can be prepared and contacted with endothelial cells derivedfrom human umbilical vein or human lung microvessels to facilitateincorporation of the nucleic acid sequence into the endothelial cells.Incorporation of the nucleic acid sequence can be detected using methodsknown in the art, such as, for example, fluorescence or staining.

In the inventive method for enhancing transport of a pharmaceuticalagent to the site of an infirmity, the infirmity can be any suitabledisease or condition. Preferably, the infirmity is cancer,cardiovascular disease, or arthritis.

In the inventive method for enhancing binding of a pharmaceutical agentto a cell in vitro or in vivo, the pharmaceutical composition isadministered to a cell in vitro or in vivo. Desirably, the cell is ananimal cell. More preferably the cell is a mammalian cell, and mostpreferably the cell is a human cell. The pharmaceutical compositionpreferably is administered to a cell in vivo. The cell can be anysuitable cell that is a desirable target for administration of thepharmaceutical composition. For example, the cell can be located in orderived from tissues of the digestive system including, for example, theesophagus, stomach, small intestine, colon, rectum, anus, liver, gallbladder, and pancreas. The cell also can be located in or derived fromtissues of the respiratory system, including, for example, the larynx,lung, and bronchus. The cell can be located in or derived from, forexample, the uterine cervix, the uterine corpus, the ovary vulva, thevagina, the prostate, the testis, and the penis, which make up the maleand female genital systems, and the urinary bladder, kidney, renalpelvis, and ureter, which comprise the urinary system. The cell can belocated in or derived from tissues of the cardiovascular system,including, for example, endothelial cells and cardiac muscle cells. Thecell also can be located in or derived from tissues of the lymphoidsystem (e.g., lymph cells), the nervous system (e.g., neurons or glialcells), and the endocrine system (e.g., thyroid cells). Preferably, thecell is located in or derived from tissues of the cardiovascular system.Most preferably, the cell is an endothelial cell. In the context of theinventive method for enhancing transport and enhancing binding of apharmaceutical agent to a cell, the pharmaceutical composition desirablycontacts more than one cell.

In another aspect of the invention, the inventive methods for enhancingtransport and enhancing binding of a pharmaceutical agent to a cell canbe used to treat tumor cells. Tumor cells exhibit an enhanced uptake ofproteins including, for example, albumin and transferrin, as compared tonormal cells. Since tumor cells are dividing at a rapid rate, theyrequire additional nutrient sources compared to normal cells. Tumorstudies of the inventive pharmaceutical compositions containingpaclitaxel and human serum albumin showed high uptake ofalbumin-paclitaxel into tumors. This has been found to be due to thepreviously unrecognized phenomenon of the albumin-drug transport byglycoprotein 60 (“gp60”) receptors, which are specific for albumin.

Thus, in accordance with another aspect of the present invention, thealbumin specific gp60 receptor and other protein transport receptorsthat are present on tumor cells can be used as a target to inhibit tumorgrowth. By blocking the gp60 receptor using antibodies against the gp60receptor or other large or small molecule compounds that bind, block, orinactivate gp60 and other protein transport receptors on tumor cells ortumor endothelial cells, it is possible to block the transport ofproteins to these cells and thereby reduce their growth rate and causecell death. Blocking of this mechanism thus results in the treatment ofa subject (e.g., a human) with cancer or another disease. Identificationof blocking/binding of the specific protein receptor is done byscreening any number of compounds against the isolated gp60 or otherreceptors, such as gp16 orgp30, or by using a whole cell preparation. Inaddition, suitable animal models also can be used for this purpose, suchas, for example, mice containing “knock-out” mutations of the genesencoding gp60 or caveolin-1, or other proteins that are specific fortransport. Thus, method of identification of compounds that block orbind gp60, gp16, gp30, or other protein receptors are within the scopeof the invention.

In addition, compounds that block or bind the gp60 receptor or otherprotein receptors can be used in the treatment of several diseases,including cancer. With respect to the treatment of cancer, the blockingor binding compound may be used as a single agent or in combination withother standard chemotherapy or chemotherapies. For example, it is usefulto treat the cancer with conventional chemotherapy, or with theinventive albumin-drug pharmaceutical compositions (which show highaccumulation in tumors), followed by compounds that block the transportof proteins to the tumor cell. Blocking compounds can be administeredprior to, or in conjunction with, other chemotherapeutic or anticanceragents. Thus, any compounds that can block or bind the gp60 receptor, orother protein receptors, are within the scope of the present invention.

The inventive albumin-drug compositions, such as e.g.,albumin-paclitaxel, albumin-docetaxel, albumin-epothilone,albumin-camptothecin, or albumin-rapamycin, and others, are useful inthe treatment of diseases. It is believed that such drug compositionsare effective due to increased receptor mediated transport of theprotein-drug composition to the required site, for example a tumor.Without wishing to be bound to any particular theory, the transport of aprotein-drug composition by receptor mediated transport resulting in atherapeutic effect is believed to be the mechanism for transport of forexample, albumin-paclitaxel compositions to a tumor, as well asalbumin-paclitaxel and albumin-rapamycin transport across the lung.Transport is effected by the presence of gp60, gp16, or gp30 in suchtissues. Accordingly, drugs and protein-drug compositions whosetransport to sites of disease, e.g., inflammation (e.g., arthritis) ortumors is associated with gp60, gp16, or gp30 receptors and that resultin a therapeutic effect are contemplated as compositions of the presentinvention.

In accordance with another aspect of the present invention, endothelialcells can be co-cultured with cells having a specific function.Incubation of endothelial cells with other cell types such as isletcells, hepatocytes, neuroendocrine cells, and others allows for requiredtransport of components such as proteins and other beneficial componentsto these cells. The endothelial cells provide for transport of thesecomponents to the cultured cell types in order to simulate in vivoconditions, i.e., where these cell types would normally be in closeproximity to endothelial cells and would depend on the endothelial cellsfor transport of nutrients, growth factors, hormone signals, etc. thatare required for their proper function. It has previously not beenpossible to adequately culture these different cell types and obtainphysiological performance when endothelial cells were absent. Thepresence of endothelial cells in culture with desired cell types allowsfor differentiation and proper functioning of islets, hepatocytes, orneuroendocrine tissue in vitro or ex vivo. Thus it is found thatcoculture of endothelial cells with islets results in islets withimproved physiological properties e.g., ability to secrete insulin, whencompared with those cultured in the absence of endothelial cells. Thistissue can then be used ex vivo or transplanted in vivo to treatdiseases caused by lack of adequate cellular function (e.g., diabetes inthe case of islet cells, hepatic dysfunction in the case of hepatocytes,and neuroendocrine disorders or pain relief in the case ofneuroendocrine cells). Cells originating from other tissues and organs(as described above) may also be cocultured with endothelial cells toprovide the same benefit. In addition, the coculture may be utilized toincorporate genetic material into the target cell types. The presence ofalbumin in these cultures is found to be greatly beneficial.

The following examples further illustrate the invention but, of course,should not be construed as in any way limiting its scope.

EXAMPLE 1

This example demonstrates the preparation of pharmaceutical compositionscomprising paclitaxel and albumin. Preparation of paclitaxel-albumincompositions is described in U.S. Pat. Nos. 5,439,686 and 5,916,596,which are incorporated in their entirety by reference. Specifically, 30mg of paclitaxel was dissolved in 3.0 ml methylene chloride. Thesolution was added to 27.0 ml of human serum albumin solution (2% w/v).Deferoxamine was added as necessary. The mixture was homogenized for 5minutes at low RPM (Vitris homogenizer, model Tempest I.Q.) in order toform a crude emulsion, and then transferred into a high pressurehomogenizer (Avestin). The emulsification was performed at 9000-40,000psi while recycling the emulsion for at least 5 cycles. The resultingsystem was transferred into a rotary evaporator, and methylene chloridewas rapidly removed at 40° C., at reduced pressure (30 mm Hg) for 20-30minutes. The resulting dispersion was translucent, and the typicalaverage diameter of the resulting paclitaxel particles was in the range50-220 nm (Z-average, Malvern Zetasizer). The dispersion was furtherlyophilized for 48 hrs. The resulting cake could be easily reconstitutedto the original dispersion by addition of sterile water or saline. Theparticle size after reconstitution was the same as beforelyophilization.

It should be recognized that the amounts, types and proportions of drug,solvents, proteins used in this example are not limiting in any way.When compared to toxicity of paclitaxel dissolved in cremophorformulations, the inventive pharmaceutical composition containingalbumin showed substantially lower toxicity.

EXAMPLE 2

This example demonstrates the preparation of a pharmaceuticalcomposition comprising amiodarone and albumin. 30 mg of amiodarone wasdissolved in 3.0 ml methylene chloride. The solution was added to 27.0ml of human serum albumin solution (1% w/v). Deferoxamine was added asnecessary. The mixture was homogenized for 5 minutes at low RPM (Vitrishomogenizer, model Tempest I.Q.) in order to form a crude emulsion, andthen transferred into a high pressure homogenizer (Avestin). Theemulsification was performed at 9000-40,000 psi while recycling theemulsion for at least 5 cycles. The resulting system was transferredinto a rotary evaporator, and methylene chloride was rapidly removed at40° C., at reduced pressure (30 mm Hg) for 20-30 minutes. The resultingdispersion was translucent, and the typical average diameter of theresulting amiodarone particles was in the range 50-220 nm (Z-average,Malvern Zetasizer). The dispersion was further lyophilized for 48 hrs.The resulting cake was easily reconstituted to the original dispersionby addition of sterile water or saline. The particle size afterreconstitution was the same as before lyophilization.

It should be recognized that the amounts, types and proportions of drug,solvents, proteins used in this example are not limiting in anyway. Whencompared to toxicity of amiodarone dissolved in tween formulations, theinventive pharmaceutical composition with albumin showed substantiallylower toxicity.

EXAMPLE 3

This example demonstrates the preparation of pharmaceutical compositionscomprising liothyronine and albumin compositions. Liothyronine (orsuitable salt) was dissolved in an aqueous alcoholic solution oralkaline solution at a concentration of 0.5-50 mg/ml. The alcoholic (oralkaline) solution was added to an albumin solution (0.1-25% w/v) andagitated. Agitation was low shear with a stirrer or high shear using asonicator or a homogenizer. At low concentrations of liothyronine,(5-1000 μg/ml) clear solutions were obtained. As the concentration wasincreased, a milky stable suspension was obtained. These solutions orsuspensions were filtered through a sterilizing filter. Organic solventswere removed by evaporation or other suitable method.

EXAMPLE 4

This example demonstrates the preparation of pharmaceutical compositionscomprising rapamycin and albumin. 30 mg of rapamycin was dissolved in 2ml chloroform/ethanol. The solution was then added into 27.0 ml of ahuman serum albumin solution (3% w/v). The mixture was homogenized for 5minutes at low RPM (Vitris homogenizer model Tempest I.Q.) in order toform a crude emulsion, and then transferred into a high pressurehomogenizer (Avestin). The emulsification was performed at 9000-40,000psi while recycling the emulsion for at least 5 cycles. The resultingsystem was transferred into a Rotavap and solvent was rapidly removed at40° C., at reduced pressure (30 mm Hg) for 20-30 minutes. The resultingdispersion was translucent and the typical average diameter of theresulting particles was in the range 50-220 nm (Z-average, MalvernZetasizer). The dispersion was further lyophilized for 48 hours. Theresulting cake was easily reconstituted to the original dispersion byaddition of sterile water or saline. The particle size afterreconstitution was the same as before lyophilization. It should berecognized that the amounts, types and proportions of drug, solvents,proteins used in this example are not limiting in anyway.

EXAMPLE 5

This example demonstrates the preparation of a pharmaceuticalcomposition comprising epothilone B and albumin. 30 mg of epothilone Bwas dissolved in 2 ml chloroform/ethanol. The solution was then addedinto 27.0 ml of a human serum albumin solution (3% w/v). Deferoxaminewas added as necessary. The mixture was homogenized for 5 minutes at lowRPM (Vitris homogenizer model Tempest I.Q.) in order to form a crudeemulsion, and then transferred into a high pressure homogenizer(Avestin). The emulsification was performed at 9000-40,000 psi whilerecycling the emulsion for at least 5 cycles. The resulting system wastransferred into a Rotavap and solvent was rapidly removed at 40° C., atreduced pressure (30 mm Hg) for 20-30 minutes. The resulting dispersionwas translucent and the typical average diameter of the resultingparticles was in the range 50-220 nm (Z-average, Malvern Zetasizer). Thedispersion was further lyophilized for 48 hours. The resulting cake waseasily reconstituted to the original dispersion by addition of sterilewater or saline. The particle size after reconstitution was the same asbefore lyophilization. It should be recognized that the amounts, typesand proportions of drug, solvents, proteins used in this example are notlimiting. When compared to toxicity of epothilone B dissolved incremophor formulations, the pharmaceutical composition comprisingalbumin showed substantially lower toxicity.

EXAMPLE 6

This example demonstrates the preparation of pharmaceutical compositionscomprising colchicine dimer and albumin. 30 mg of colchicine-dimer wasdissolved in 2 ml chloroform/ethanol. The solution was then added into27.0 ml of human serum albumin solution (3% w/v). Deferoxamine was addedas necessary. The mixture was homogenized for 5 minutes at low RPM(Vitris homogenizer model Tempest I.Q.) in order to form a crudeemulsion, and then transferred into a high pressure homogenizer(Avestin). The emulsification was performed at 9000-40,000 psi whilerecycling the emulsion for at least 5 cycles. The resulting system wastransferred into a Rotavap and solvent was rapidly removed at 40° C., atreduced pressure (30 mm Hg) for 20-30 minutes. The resulting dispersionwas translucent and the typical average diameter of the resultingparticles was in the range 50-220 nm (Z-average, Malvern Zetasizer). Thedispersion was further lyophilized for 48 hours. The resulting cake waseasily reconstituted to the original dispersion by addition of sterilewater or saline. The particle size after reconstitution was the same asbefore lyophilization. It should be recognized that the amounts, typesand proportions of drug, solvents, proteins used in this example are notlimiting. When compared to toxicity of the colchicines dimer dissolvedin tween, the pharmaceutical composition comprising albumin showedsubstantially lower toxicity.

EXAMPLE 7

This example demonstrates the preparation of pharmaceutical compositionscomprising docetaxel and albumin. 30 mg of docetaxel was dissolved in 2ml chloroform/ethanol. The solution was then added into 27.0 ml of humanserum albumin solution (3% w/v). Deferoxamine was added as necessary.The mixture was homogenized for 5 minutes at low RPM (Vitris homogenizermodel Tempest I.Q.) in order to form a crude emulsion, and thentransferred into a high pressure homogenizer (Avestin). Theemulsification was performed at 9000-40,000 psi while recycling theemulsion for at least 5 cycles. The resulting system was transferredinto a Rotavap and solvent was rapidly removed at 40° C., at reducedpressure (30 mm Hg) for 20-30 minutes. The resulting dispersion wastranslucent and the typical average diameter of the resulting particleswas in the range 50-220 nm (Z-average, Malvern Zetasizer). Thedispersion was further lyophilized for 48 hours. The resulting cake waseasily reconstituted to the original dispersion by addition of sterilewater or saline. The particle size after reconstitution was the same asbefore lyophilization. It should be recognized that the amounts, typesand proportions of drug, solvents, and proteins used in this example arenot limiting. When compared to toxicity of the docetaxel dissolved intween/ethanol which is the standard solvent for this drug, thepharmaceutical composition comprising albumin showed substantially lowertoxicity.

EXAMPLE 8

This example demonstrates the preparation of pharmaceutical compositionscomprising docetaxel and albumin. 150 mg of docetaxel was dissolved in 1ml ethyl acetate/butyl acetate and 0.5 ml of an oil for example soybeanoil or vitamin E oil. Other ratios of solvents and oils were used andthese compositions are also contemplated as part of the invention. Asmall quantity of a negatively charged component was also optionallyadded, e.g., benzoic acid (0.001%-0.5%) The solution was then added into27.0 ml of human serum albumin solution (5% w/v). Deferoxamine was addedas necessary. The mixture was homogenized for 5 minutes at low RPM(Vitris homogenizer model Tempest I.Q.) in order to form a crudeemulsion, and then transferred into a high pressure homogenizer(Avestin). The emulsification was performed at 9000-40,000 psi whilerecycling the emulsion for at least 5 cycles. The resulting system wastransferred into a Rotavap and solvent was rapidly removed at 40° C., atreduced pressure (30 mm Hg) for 20-30 minutes. The resulting dispersionwas translucent and the typical average diameter of the resultingparticles was in the range 50-220 nm (Z-average, Malvern Zetasizer). Thedispersion was further lyophilized for 48 hours. The resulting cake waseasily reconstituted to the original dispersion by addition of sterilewater or saline. The particle size after reconstitution was the same asbefore lyophilization. It should be recognized that the amounts, typesand proportions of drug, solvents, proteins used in this example are notlimiting. When compared to toxicity of the docetaxel dissolved intween/ethanol which is the standard solvent for this drug, thepharmaceutical composition comprising albumin showed substantially lowertoxicity.

EXAMPLE 9

This example demonstrates the preparation of pharmaceutical compositionscomprising a taxane IDN5390 and albumin. 150 mg of IDN5390 was dissolvedin 1 ml ethyl acetate/butyl acetate and 0.5 ml of an oil for examplesoybean oil or vitamin E oil. Other ratios of solvents and oils wereused and these compositions are also contemplated as part of theinvention. A small quantity of a negatively charged component was alsooptionally added, e.g., benzoic acid (0.001%-0.5%) The solution was thenadded into 27.0 ml of human serum albumin solution (5% w/v).Deferoxamine was added as necessary. The mixture was homogenized for 5minutes at low RPM (Vitris homogenizer model Tempest I.Q.) in order toform a crude emulsion, and then transferred into a high pressurehomogenizer (Avestin). The emulsification was performed at 9000-40,000psi while recycling the emulsion for at least 5 cycles. The resultingsystem was transferred into a Rotavap and solvent was rapidly removed at40° C., at reduced pressure (30 mm Hg) for 20-30 minutes. The resultingdispersion was translucent and the typical average diameter of theresulting particles was in the range 50-220 nm (Z-average, MalvernZetasizer). The dispersion was further lyophilized for 48 hours. Theresulting cake was easily reconstituted to the original dispersion byaddition of sterile water or saline. The particle size afterreconstitution was the same as before lyophilization. It should berecognized that the amounts, types and proportions of drug, solvents,proteins used in this example are not limiting. When compared totoxicity of the IDN5390 dissolved in tween, the pharmaceuticalcomposition comprising albumin showed substantially lower toxicity.

EXAMPLE 10

This example demonstrates the preparation of pharmaceutical compositionscomprising a taxane IDN5109 and albumin. 150 mg of IDN5109 was dissolvedin 2 ml chloroform/ethanol. Other ratios of solvents and oils were usedand these compositions are also contemplated as part of the invention. Asmall quantity of a negatively charged component was also optionallyadded, e.g., benzoic acid (0.001%-0.5%) The solution was then added into27.0 ml of human serum albumin solution (5% w/v). Deferoxamine was addedas necessary. The mixture is homogenized for 5 minutes at low RPM(Vitris homogenizer model Tempest I.Q.) in order to form a crudeemulsion, and then transferred into a high pressure homogenizer(Avestin). The emulsification was performed at 9000-40,000 psi whilerecycling the emulsion for at least 5 cycles. The resulting system wastransferred into a Rotavap and solvent was rapidly removed at 40° C., atreduced pressure (30 mm Hg) for 20-30 minutes. The resulting dispersionwas translucent and the typical average diameter of the resultingparticles was in the range 50-220 nm (Z-average, Malvern Zetasizer). Thedispersion was further lyophilized for 48 hours. The resulting cake waseasily reconstituted to the original dispersion by addition of sterilewater or saline. The particle size after reconstitution was the same asbefore lyophilization. It should be recognized that the amounts, typesand proportions of drug, solvents, and proteins used in this example arenot limiting. When compared to toxicity of the IDN5109 dissolved intween, the pharmaceutical composition comprising albumin showedsubstantially lower toxicity.

EXAMPLE 11

This example demonstrates the preparation of a pharmaceuticalcomposition comprising 10-hydroxy camptothecin (10HC) and albumin. 30 mgof 10-HC was dissolved in 2.0 ml DMF/methylene chloride/soybean oil. Thesolution was then added into 27.0 ml of a human serum albumin solution(3% w/v). The mixture was homogenized for 5 minutes at low RPM (Vitrishomogenizer model Tempest I.Q.) in order to form a crude emulsion, andthen transferred into a high pressure homogenizer (Avestin). Theemulsification was performed at 9000-40,000 psi while recycling theemulsion for at least 5 cycles. The resulting system was transferredinto a Rotavap and solvent was rapidly removed at 40° C., at reducedpressure (30 mm Hg) for 20-30 minutes. The resulting dispersion wastranslucent and the typical average diameter of the resulting particleswas in the range 50-220 nm (Z-average, Malvern Zetasizer). Thedispersion was further lyophilized for 48 hours. The resulting cake waseasily reconstituted to the original dispersion by addition of sterilewater or saline. The particle size after reconstitution was the same asbefore lyophilization. It should be recognized that the amounts, typesand proportions of drug, solvents, proteins used in this example are notlimiting in anyway.

EXAMPLE 12

This example demonstrates the preparation of a pharmaceuticalcomposition comprising cyclosporine and albumin. 30 mg of cyclosporinewas dissolved in 3.0 ml methylene chloride. The solution was then addedinto 27.0 ml of a human serum albumin solution (1% w/v). The mixture washomogenized for 5 minutes at low RPM (Vitris homogenizer model TempestI.Q.) in order to form a crude emulsion, and then transferred into ahigh pressure homogenizer (Avestin). The emulsification was performed at9000-40,000 psi while recycling the emulsion for at least 5 cycles. Theresulting system was transferred into a Rotavap and methylene chloridewas rapidly removed at 40° C., at reduced pressure (30 mm Hg) for 20-30minutes. The resulting dispersion was translucent and the typicalaverage diameter of the resulting particles was in the range 50-220 nm(Z-average, Malvern Zetasizer). The dispersion was further lyophilizedfor 48 hours. The resulting cake was easily reconstituted to theoriginal dispersion by addition of sterile water or saline. The particlesize after reconstitution was the same as before lyophilization.

EXAMPLE 13

This example demonstrates the preparation of a pharmaceuticalcomposition containing oil and comprising cyclosporine and albumin. 30mg of cyclosporine was dissolved in 3.0 ml of a suitable oil (sesame oilcontaining 10% orange oil). The solution was then added into 27.0 ml ofa human serum albumin solution (1% v/w). The mixture was homogenized for5 minutes at low RPM (Vitris homogenizer, model Tempest I.Q.) in orderto form a crude emulsion, and then transferred into a high pressurehomogenizer (Avestin). The emulsification as performed at 9000-40,000psi while recycling the emulsion for at least 5 cycles. The resultingdispersion had a typical average diameter in range of 50-220 nm(Z-average, Malvern Zetasizer). The dispersion was used directly orlyophilized for 48 hours by optionally adding a suitable cryoprotectant.The resulting cake was easily reconstituted to the original dispersionby addition of sterile water or saline. It should be recognized that theamounts, types and proportions of drug, solvents, and proteins used inthis example are not limiting in anyway.

EXAMPLE 14

This example demonstrates the preparation of a pharmaceuticalcomposition comprising amphotericin and albumin. 30 mg of amphotericinwas dissolved in 3.0 ml methyl pyrrolidinone/methylene chloride. Thesolution was added to 27.0 ml of a human serum albumin solution (1%w/v). The mixture was homogenized for 5 minutes at low RPM (Vitrishomogenizer, model Tempest I.Q.) in order to form a crude emulsion, andthen transferred into a high pressure homogenizer (Avestin). Theemulsification was performed at 9000-40,000 psi while recycling theemulsion for at least 5 cycles. The resulting system was transferredinto a rotary evaporator, and solvent was rapidly removed at 40° C., atreduced pressure (30 mm Hg) for 20-30 minutes. The resulting dispersionwas translucent, and the typical average diameter of the resultingamphotericin particles was between 50-220 nm (Z-average, MalvernZetasizer). The dispersion was further lyophilized for 48 hrs. Theresulting cake could be easily reconstituted to the original dispersionby addition of sterile water or saline. The particle size afterreconstitution was the same as before lyophilization. It should berecognized that the amounts, types and proportions of drug, solvents,and proteins used in this example are not limiting in anyway. Additionof other components such as lipids, bile salts, etc., also resulted insuitable formulations.

EXAMPLE 15

This example demonstrates preclinical pharmacokinetics andpharmacodynamics of a pharmaceutical composition comprising albumin andpaclitaxel.

Several preclinical pharmacokinetic studies in mice and rats wereconducted to evaluate the possible advantages of albumin-paclitaxelpharmaceutical compositions over cremophor-paclitaxel (Taxol)pharmaceutical compositions. These studies demonstrated: (1) that thepharmacokinetics of albumin-paclitaxel in rats was linear, whereas Taxolpharmacokinetics were non-linear with respect to dose, (2)pharmaceutical compositions comprising albumin and paclitaxel exhibiteda lower plasma AUC and C_(max), suggesting more rapid distribution ofalbumin-paclitaxel compositions to tissues compared with Taxol(excretion is similar), (3) pharmaceutical compositions comprisingalbumin and paclitaxel exhibited a lower C_(max), which possiblyaccounts for the reduced toxicities associated with peak blood levelsrelative to Taxol, (4) the half-life of pharmaceutical compositionscomprising albumin and paclitaxel exhibited was approximately 2-foldhigher in rats and 4-fold higher in tumor bearing mice relative toTaxol, and (5) the metabolism of paclitaxel in pharmaceuticalcompositions comprising albumin and paclitaxel was slower than in Taxolpharmaceutical compositions. At 24 hours post-injection in rats, 44% oftotal radioactivity was still associated with paclitaxel forpharmaceutical compositions comprising albumin and paclitaxel, comparedto only 22% for Taxol. The ultimate effect of the abovepharmacodynamics, i.e., enhanced intra-cellular uptake, prolongedhalf-life and slower metabolism for pharmaceutical compositionscomprising albumin and paclitaxel exhibited resulted in a tumor AUC1.7-fold higher, tumor C_(max) 1.2-fold higher, and tumor half-life1.7-fold longer than for Taxol in tumor bearing mice.

EXAMPLE 16

This example demonstrates reduced side effects and reduced toxicityassociated with pharmaceutical compositions comprising paclitaxel andalbumin.

Due to the unique nature of pharmaceutical compositions comprisingpaclitaxel and albumin in the absence of cremophor, the toxicity ofpharmaceutical compositions comprising paclitaxel and albumin issubstantially lower than Taxol. In preclinical studies in mice and rats,a single dose acute toxicity study in mice showed an LD₅₀ doseapproximately 59 times greater for pharmaceutical compositionscomprising paclitaxel and albumin than for Taxol. In a multiple dosetoxicity study in mice, the LD₅₀ dose was approximately 10-fold greaterfor pharmaceutical compositions comprising paclitaxel and albumin thanfor Taxol. A further study evaluated the degree of myelosuppression inrats treated with pharmaceutical compositions comprising paclitaxel andalbumin and Taxol. The results showed that at equi-dose, pharmaceuticalcompositions comprising paclitaxel and albumin produced considerablyless myelosuppression in rats than Taxol. In an acute toxicity study inrats, cerebral cortical necrosis or severe neurotoxicity was observed inanimals receiving Taxol at 9 mg/kg but was absent in animals receiving apharmaceutical composition comprising paclitaxel and albumin at a doseof up to 120 mg/kg. Thus the presence of albumin in a pharmaceuticalcomposition comprising paclitaxel results in a substantial reduction inside effects and toxicity when compared to conventional pharmaceuticalcompositions comprising paclitaxel.

EXAMPLE 17

This example demonstrates the clinical effects of a pharmaceuticalcomposition comprising paclitaxel and albumin in humans.

Clinical studies in over 500 human patients to date provide evidencesupporting the reduction in toxicity and side-effects for apharmaceutical composition comprising paclitaxel and albumin(“albumin-paclitaxel”) when compared with cremophor-paclitaxelcompositions (Taxol). In a phase I study of 19 patients, the maximumtolerated dose of albumin-paclitaxel given every 3 weeks was 300 mg/m².This is substantially higher than the generally administered dose ofcremophor-paclitaxel which is 175 mg/m² given once every 3 weeks. Thehematological toxicities in these patients were mild with nohypersensitivities, mild neuropathies, and no administration relatedside effects such as venous irritation, etc.

In another phase I study of 27 patients, the maximum tolerated dose ofalbumin-paclitaxel given on a weekly schedule was 125-150 mg/m². This issubstantially higher than the generally administered dose ofcremophor-paclitaxel which is 80 mg/m² when given on a weekly schedule.The hematological toxicities in these patients were mild with nohypersensitivities, mild neuropathies, and no administration relatedside effects such as venous irritation, etc.

In two phase II studies of albumin-paclitaxel given at either 175 or 300mg/m² every 3 weeks in 43 and 63 patients respectively, hematologicaltoxicities were low with only 7% and 24% of patients with ANC <500/mm³at 175 mg/m² and 300 mg/m² respectively. Severe neuropathy occurred in0% and 14% of patients for 175 mg/m² and 300 mg/m² respectively. Therewas no incidence of severe hypersensitivity, and no incidence ofadministration related side effects such as venous irritation, pain oninjection, etc. These side effects were substantially lower thanexperienced with Taxol.

In phase III trials comparing the albumin-paclitaxel composition ABI-007against Taxol (which contains cremophor-paclitaxel), the dose of ABI-007was substantially higher (260 mg/m² vs. 175 mg/m² for Taxol) indicatingit was better tolerated. The albumin-paclitaxel compositions alsodemonstrated significantly reduced neutropenia when compared tocremophor-paclitaxel.

EXAMPLE 18

This example demonstrates enhanced preclinical efficacy using apharmaceutical composition comprising albumin and paclitaxel.

An in vitro cytotoxicity study comparing the effect ofalbumin-paclitaxel and Taxol on cervical squamous cell carcinoma A431showed an approximately 4-fold increase in cytotoxic activity foralbumin-paclitaxel with an IC₅₀ of 0.0038 and 0.012 μg/ml foralbumin-paclitaxel and Taxol respectively.

In five different human xenograft tumor models in athymic mice (MX-1mammary, NCI-H522 lung, SK-OV-3 ovarian, PC-3 prostate, and HT-29colon), the MTD or equitoxic dose of ABI-007 was 1.5-3.4-fold higherthan for Taxol, and resulted in statistically significant improvement intumor growth delay (p<0.05) in all tumors except the lung tumor(p=0.15).

In the MX 1 mammary model, one hundred percent (100%) ofalbumin-paclitaxel treated animals survived 103 days, as compared to20-40% surviving in groups treated with equivalent doses of Taxol.

EXAMPLE 19

This example demonstrates enhanced clinical efficacy using apharmaceutical composition comprising albumin and paclitaxeladministered infra-arterially.

In a Phase I/II Study of intra-arterial administration of apharmaceutical composition comprising albumin and paclitaxel, asdescribed herein, patients were enrolled for head & neck cancer (N=31)and cancer of the anal canal (N=12). The dose escalated from 120-300mg/m² given over 30 minutes by percutaneous superselectiveintra-arterial infusion, q 3-4-wk. Head and neck cancer patientsexhibited a response rate of 76% (N=29), while patients with cancer ofthe anal canal exhibited a response rate 64% (N=11).

EXAMPLE 20

This example demonstrates the preparation of a pharmaceuticalcomposition containing 3% oil and comprising propofol and albumin.

An oil-in-water emulsion containing 1% (by weight) of propofol wasprepared as follows. The aqueous phase was prepared by adding glycerol(2.25% by weight) and human serum albumin (0.5% by weight) into waterfor injection and stirred until dissolved. The aqueous phase was passedthrough a filter (0.2 um filter). The oil phase was prepared bydissolving egg lecithin (0.4% by weight) and propofol (1% by weight)into soybean oil (3% by weight) at about 50° C.-60° C. and was stirreduntil dissolved. The oil phase was added to the aqueous phase andhomogenized at 10,000 RPM for 5 min. The crude emulsion was highpressure homogenized at 20,000 psi and recirculated for 15 cycles at 5°C. Alternately, discrete passes through the homogenizer were used. Thefinal emulsion was filtered (0.2 μm filter) and stored under nitrogen.The resulting pharmaceutical composition contained the following generalranges of components (weight %): propofol 0.5-5%; human serum albumin0.5-3%; soybean oil 0.5-3.0%; egg lecithin 0.12-1.2%; glycerol 2.25%;water for injection q.s. to 100; pH 5-8. Suitable chelators, e.g.,deferoxamine (0.001-0.1%), were optionally added.

EXAMPLE 21

This example demonstrates the preparation of a pharmaceuticalcomposition containing 5% oil and comprising propofol and albumin.

An oil-in-water emulsion containing 1% (by weight) of propofol wasprepared as follows. The aqueous phase was prepared by adding glycerol(2.25% by weight) and human serum albumin (0.5% by weight) into waterfor injection and was stirred until dissolved. The aqueous phase waspassed through a filter (0.2 um filter). The oil phase as prepared bydissolving egg lecithin (0.8% by weight) and propofol (1% by weight)into soybean oil (5% by weight) at about 50° C.-60° C. and was stirreduntil dissolved. The oil phase was added to the aqueous phase andhomogenized at 10,000 RPM for 5 min. The crude emulsion was highpressure homogenized at 20,000 psi and recirculated for 15 cycles at 5°C. Alternately, discrete passes through the homogenizer were used. Thefinal emulsion was filtered (0.2 μm filter) and stored under nitrogen.The resulting pharmaceutical composition contained the following generalranges of components (weight %): propofol 0.5-5%; human serum albumin0.5-3%; soybean oil 0.5-10.0%; egg lecithin 0.12-1.2%; glycerol 2.25%;water for injection q.s. to 100; pH 5-8. Suitable chelators, e.g.,deferoxamine (0.001-0.1%), were optionally added

EXAMPLE 22

This example demonstrates the preparation of a pharmaceuticalcomposition comprising propofol and albumin that is free of oil.

Using the procedure similar to that described in Example 18, propofolcompositions containing albumin and tween 80 were prepared. The aqueousphase was prepared by adding glycerol (2.25% by weight), human serumalbumin (0.5% by weight), tween 80 (1.5% by weight) and deferoxaminemesylate (0.1% by weight) into water for injection and stirred untildissolved. The aqueous phase was passed through a filter (0.2 μmfilter). Propofol (1% by weight) was added to the aqueous phase andhomogenized at 10,000 RPM for 5 min. The crude emulsion was highpressure homogenized at 20,000 psi and recirculated for 15 cycles at 5°C. Alternately, discrete passes through the homogenizer were used. Thefinal emulsion was filtered (0.2 um filter) and stored under nitrogen.The resulting pharmaceutical composition contained the following generalranges of components (weight %): propofol 0.5-5; human serum albumin0.5-3%; tween 80 0.1-1.5%; deferoxamine mesylate 0.0001-0.1%; glycerol2.25%; water for injection q.s. to 100; pH 5-8.

EXAMPLE 23

This example demonstrates the preparation of a pharmaceuticalcomposition comprising propofol, albumin, and vitamin E-TPGS, which isfree of oil.

Using the procedure similar to that described in Example 19, propofolcompositions containing albumin and vitamin E-TPGS were prepared. Theaqueous phase was prepared by adding glycerol (2.25% by weight), humanserum albumin (0.5% by weight), vitamin E-TPGS (1% by weight) anddeferoxamine mesylate (0.1% by weight) into water for injection and wasstirred until dissolved. The aqueous phase was passed through a filter(0.2 um filter). Propofol (1% by weight) was added to the aqueous phaseand homogenized at 10,000 RPM for 5 min. The crude emulsion was highpressure homogenized at 20,000 psi and recirculated for 15 cycles at 5°C. Alternately, discrete passes through the homogenizer were used. Thefinal emulsion was filtered (0.2 μm filter) and stored under nitrogen.The resulting pharmaceutical composition contained the following generalranges of components (weight %): propofol 0.5-5; human serum albumin0.5-3%; vitamin E-TPGS 0.5-4.0%; optionally deferoxamine mesylate0.0001-0.1%; glycerol 2.25%; water for injection q.s. to 100; pH 5-8.

EXAMPLE 24

This example demonstrates the preparation of a pharmaceuticalcomposition comprising propofol, albumin, vitamin E-TPGS, and 1% oil.

An emulsion containing 1% (by weight) of propofol was prepared by thefollowing method. The aqueous phase was prepared by adding glycerol(2.25% by weight) and human serum albumin (0.5% by weight) into waterfor injection and stirred until dissolved. The aqueous phase was passedthrough a filter (0.2 μm filter). Surfactant, e.g., Vitamin E-TPGS(0.5%), was added to aqueous phase. The oil phase consisted of propofol(1% by weight) and 1% soybean oil. The oil phase was added to theaqueous phase and homogenized at 10,000 RPM for 5 min. The crudeemulsion was high pressure homogenized at 20,000 psi and recirculatedfor up to 15 cycles at 5° C. Alternatively, discrete passes through thehomogenizer were used. The final emulsion was filtered (0.2 μm filter)and stored under nitrogen.

The resulting pharmaceutical composition contained the following generalranges of components (weight %): propofol 0.5-5%; human serum albumin0.01-3%; Vitamin E—TPGS 0.1-2%; soybean or other oil (0.1%-5%); glycerol2.25%; water for injection q.s. to 100; pH 5-8. Deferoxamine wasoptionally added (0.001%-0.1% by weight).

EXAMPLE 25

This example demonstrates the preparation of a pharmaceuticalcomposition comprising propofol, albumin, vitamin E-TPGS, 1% oil, and anegatively charged component.

An emulsion containing 1% (by weight) of propofol was prepared by thefollowing method. The aqueous phase was prepared by adding glycerol(2.25% by weight) and human serum albumin (0.5% by weight) into waterfor injection and was stirred until dissolved. The aqueous phase waspassed through a filter (0.2 μm filter). Surfactant, e.g., VitaminE-TPGS (0.5%), was added to aqueous phase. The oil phase consisted ofpropofol (1% by weight) and 1% soybean oil. A small quantity ofnegatively charged component (0.001%-1%), e.g., a phospholipid or bilesalt was added. The oil phase was added to the aqueous phase andhomogenized at 10,000 RPM for 5 min. The crude emulsion was highpressure homogenized at 20,000 psi and recirculated for up to 15 cyclesat 5° C. Alternatively, discrete passes through the homogenizer wereused. The final emulsion was filtered (0.2 μm filter) and stored undernitrogen.

The resulting pharmaceutical composition contained the following generalranges of components (weight %): propofol 0.5-5%; human serum albumin0.01-3%; Vitamin E-TPGS 0.1-2%; soybean or other oil (0.1%-5%); glycerol2.25%; water for injection q.s. to 100; pH 5-8. Deferoxamine wasoptionally added (0.001%-0.1% by weight).

EXAMPLE 26

This example demonstrates the preparation of a pharmaceuticalcomposition comprising propofol, albumin, vitamin E-TPGS, 1% oil, and anegatively charged component (sodium deoxycholate).

An emulsion containing 1% (by weight) of propofol was prepared by thefollowing method. The aqueous phase was prepared by adding glycerol(2.25% by weight) and human serum albumin (0.5% by weight) into waterfor injection and stirred until dissolved. The aqueous phase was passedthrough a filter (0.2 μm filter). Surfactant, e.g., Vitamin E-TPGS(0.5%), was added to aqueous phase. The oil phase consisted of propofol(1% by weight) and 1% soybean oil. A small quantity of negativelycharged component (0.001%-1%), e.g., sodium deoxycholate was added. Theoil phase was added to the aqueous phase and homogenized at 10,000 RPMfor 5 min. The crude emulsion was high pressure homogenized at 20,000psi and recirculated for up to 15 cycles at 5° C. Alternately, discretepasses through the homogenizer were used. The final emulsion wasfiltered (0.2 μm filter) and stored under nitrogen.

The resulting pharmaceutical composition contained the following generalranges of components (weight %): propofol 0.5-5%; human serum albumin0.01-3%; Vitamin E-TPGS 0.1-2%; soybean or other oil (0.1%-5%); glycerol2.25%; water for injection q.s. to 100; pH 5-8. Deferoxamine wasoptionally added (0.001%-0.1% by weight).

EXAMPLE 27

This example demonstrates the preparation of a pharmaceuticalcomposition comprising propofol, albumin, vitamin E-TPGS, 1% oil, and anegatively charged component (phospholipids, bile salts, polyaminoacidsetc).

An emulsion containing 1% (by weight) of propofol was prepared asfollows. The aqueous phase was prepared by adding glycerol (2.25% byweight) and human serum albumin (0.5% by weight) into water forinjection and stirred until dissolved. The aqueous phase was passedthrough a filter (0.2 μm filter). Surfactant, e.g., Vitamin E-TPGS(0.5%), was added to aqueous phase. The oil phase consisted of propofol(1% by weight) and 1% soybean oil. A small quantity of negativelycharged component (0.001%-1%), e.g., phosphatidyl choline was added. Theoil phase was added to the aqueous phase and homogenized at 10,000 RPMfor 5 min. The crude emulsion was high pressure homogenized at 20,000psi and recirculated for up to 15 cycles at 5° C. Alternatively,discrete passes through the homogenizer were used. The final emulsionwas filtered (0.2 μm filter) and stored under nitrogen.

The resulting pharmaceutical composition contained the following generalranges of components (weight %): propofol 0.5-5%; human serum albumin0.01-3%; Vitamin E-TPGS 0.1-2%; soybean or other oil (0.1%-5%); glycerol2.25%; water for injection q.s. to 100; pH 5-8. Deferoxamine wasoptionally added (0.001%-0.1% by weight).

EXAMPLE 28

This example demonstrates the binding of propofol to albumin.

The binding of propofol to albumin was determined as follows. Solubilityof propofol was tested in water and in solutions containing albumin. 250μL of propofol was added to 10 mL of a water or albumin solution andstirred for 2 hours in a scintillation vial. The solution was thentransferred to a 15 mL polyethylene centrifuge tube and kept at 40° C.for about 16 hours. Samples of water and albumin solutions were assayedfor propofol. Solubility of propofol in water was determined to be 0.12mg/ml. Solubility of propofol in albumin solutions was dependent on theconcentration of albumin and increased to 0.44 mg/ml when the albuminconcentration was 2% (20 mg/ml). The solutions were ultrafilteredthrough a 30 kD MWCO filter and the filtrates were assayed for propofol.It was found that for the propofol/water solution, 61% of the propofolcould be recovered in the filtrate whereas for the propofol/albuminsolution, only 14% was recovered in the filtrate, indicating asubstantial binding of propofol with albumin. Based on these results,addition of albumin to pharmaceutical compositions comprising propofolresult in a decrease in the amount of free propofol due to albuminbinding of the propofol.

EXAMPLE 29

This example demonstrates the reduction of free propofol in apharmaceutical composition by filtration/membrane contact.

As observed in the experiments described in Example 28, filtration orultrafiltration of pharmaceutical compositions comprising propofolresults in a reduction in the amount of free propofol. Diprivan and apharmaceutical composition prepared in accordance with the presentinvention containing albumin, each of which contained 1% propofol (10mg/ml), were ultrafiltered using a 30 kD membrane. The amount of freepropofol was measured in the filtrate using HPLC. The concentration offree propofol in the filtrate was about 17 μg/ml for Diprivan, while theconcentration of free propofol in the filtrate was about 7 μg/ml for theinventive pharmaceutical composition. The results correspond to aneffective reduction of free propofol by greater than a factor of 2 forpharmaceutical composition comprising propofol and albumin.

EXAMPLE 30

This example demonstrates administration of a pharmaceutical compositioncomprising propofol and albumin to humans.

A randomized, double-blind clinical trial was conducted to compareadverse skin sensations of a pharmaceutical composition comprisingpropofol and albumin with that of a commercially available propofolformulation, Diprivan. Trials were conducted in compliance with GoodClinical Practices and informed consent was taken from the subjects.Adult human subjects of either sex were eligible for participation ifthey had unbroken, apparently normal skin of dorsal side of their hands.The formulations originally stored in a refrigerator were brought toroom temperature and then 10 μL of the formulations was placed slowly onthe back side of both the hands of a subject simultaneously. The overallreaction and feel on their hands for the formulations were noted. Theresults of this study are set forth in Table 1.

TABLE 1 % of subjects with % of subjects with Diprivan ABI-Propofolsensation sensation Order of Mild warm or Mild warm or a test on astinging No stinging No subject or biting sensation or biting sensation1st incidence 0.0 100.0 75 25

EXAMPLE 31

This example demonstrates the use of deferoxamine as antioxidant in apharmaceutical composition comprising propofol.

Pharmaceutical compositions comprising propofol and deferoxaminemesylate, and containing tween or TPGS were stored at 4°, 25°, or 40° C.to test the effect of deferoxamine mesylate in preventing oxidation ofpropofol. The concentration of propofol was measured for theseformulations over time to determine the antioxidant activity ofdeferoxamine. The data is reported below in Tables 2 and 3 as % potencyrelative to time zero.

TABLE 2 Albumin/tween formulation 1 month Storage Temp 4° C. 25° C. 40°C. CONTROL 100% 88% 48% 0.01% Def 101% 89% 61%  0.1% Def 103% 89% 64%

TABLE 3 Albumin/TPGS formulation 1 month Storage Temp 4° C. 25° C. 40°C. CONTROL 99% 73% 42% 0.01% DEF 99% 87% 55%  0.1% DEF 99% 85% 58%

Under these conditions, deferoxamine was efficient in reducing the levelof oxidation of propofol. The effect was more pronounced at highertemperatures. No significant oxidation occurred at 4° C. This study wasconducted using stoppers that were not inert or Teflon coated.

EXAMPLE 32

This example demonstrates intrapulmonary delivery of a pharmaceuticalcomposition comprising paclitaxel and albumin (ABI-007).

The purpose of this study was to determine the time course of[³H]ABI-007 in blood and select tissues following intratrachealinstillation to Sprague Dawley rats.

The target volume of the intratracheal dose formulation to beadministered to the animals was calculated based on a dose volume of 1.5mL per kg body weight. The dosing apparatus consisted of a Penn-Centurymicrosprayer (Model 1A-1B; Penn-Century, Inc., Philadelphia, Pa.;purchased from DeLong Distributors, Long Branch, N.J.) attached to a1-mL gas-tight, luer-lock syringe. The appropriate volume of dosepreparation was drawn into the dosing apparatus, the filled apparatuswas weighed and the weight-recorded. A catheter was placed in thetrachea of the anesthetized animal, the microsprayer portion of thedosing apparatus was placed into the trachea through the catheter, andthe dose was administered. After dose administration the empty dosingapparatus was reweighed and the administered dose was calculated as thedifference in the weights of the dosing apparatus before and afterdosing. The average dose for all animals was 4.7738±0.0060 (CV 1.5059)mg paclitaxel per kg body weight.

Blood samples of approximately 250 μL were collected from the indwellingjugular cannulas of JVC rats at the following predetermined post-dosingtime points: 1, 5, 10, 15, 30, and 45 minutes (min), and 1, 4, 8, and 24hours (h). The 24-h blood samples, as well as blood samples collectedfrom animals sacrificed at 10 min, 45 min, and 2 h, were collected viacardiac puncture from anesthetized rats at sacrifice. All blood samplesanalyzed for total radioactivity were dispensed into pre-weighed sampletubes, and the sample tubes were reweighed, and the weight of eachsample was calculated by subtraction. The blood samples collected fromthe jugular vein as well as the 250-μL aliquots of blood collected fromeach animal at sacrifice were assayed for total tritium content.

For all rats, the maximum concentration of tritium in blood was observedat 5 min (0.0833 hr) post dosing. The elimination half-life of tritium,determined over the time interval from 4 h to 24 h, ranged from 19.73 hto 43.02 h. It should be noted that this interval includes only threedata points, which may account for the variability in this parameter.The apparent clearance of tritium from blood was on the order of 0.04L/h. The results of these experiments are set forth below in Table 4.

TABLE 4 Noncompartmental Analysis of Blood Tritium Concentration(mg-eq/L) vs. Time Profiles in Rats After Intratracheal Instillation of[³H]ABI-007 Parameter Mean +/− SD C_(max) (mg-eq/L) 1.615 +/− 0.279T_(max) (hr) 0.0833 +/− 0.0   t½ beta (hr) 33.02 +/− 1.99  AUClast(mg-eq × hr/L) 7.051 +/− 1.535 Cl/F (L/hr) 0.0442 +/− 0.0070 Fa(Bioavailability) 1.229 +/− 0.268

The mean blood concentration of [³H]ABI-007-derived radioactivity afteran intravenous dose to rats was analyzed as a function of time in orderto evaluate the bioavailability of tritium derived from an intratrachealdose of [³H]ABI-007. This analysis resulted in a 24-hour AUC (AUClast)of 6.1354 mg-eq □ hr/L. Based on these data, radioactivity derived fromthe intratracheal dose of [³H]ABI-007 is highly bioavailable. Theseanalyses are based on total radioactivity.

Tritium derived from [³H]ABI-007 is rapidly absorbed after intratrachealinstillation. The average absorption and elimination half-lives (k01half-life and k10 half-life, respectively) for tritium in blood after anintratracheal dose of [³H]ABI-007 (mean+/−SD) were 0.0155+/−0.0058 hrand 4.738+/−0.366 hr, respectively. The average apparent clearance oftritium from blood was 0.1235+/−0.0180 L/hr (see Table 4 above).

Tritium derived from [³H]ABI-007 was absorbed and distributed afterintratracheal administration. The time course of tritium in blood waswell described by a two-compartment model, with mean absorption andelimination half-lives of 0.0155 and 4.738 hr, respectively.Approximately 28% of the administered dose was recovered in the lung at10 min after the intratracheal dose. A maximum of less than 1% of thedose was recovered in other tissues, excluding the gastrointestinaltract, at all time points examined.

Based on results from a previously conducted intravenous dose study with[³H]Capxol™, the bioavailability of tritium derived from theintratracheal dose was 1.229±0.268 (mean±SD) for the three animals inthis dose group. It should be noted, however, that this estimate ofbioavailability is based on total radioactivity. Surprisingly,paclitaxel delivered by the pulmonary route using invention compositionswith albumin was rapidly bioavailable indicating excellent transportacross pulmonary endothelium. No toxicity in the animals was noted,which was surprising since pulmonary delivery of cytotoxics is known tocause lung toxicities.

A fair amount of radioactivity was present in the gastrointestinal tract(including contents) at 24 hr post dosing (27% for the intratrachealdose). The presence of tritium in the gastrointestinal tract may be dueto biliary excretion or clearance of tritium from the respiratory tractvia mucociliary clearance with subsequent swallowing.

EXAMPLE 33

This example demonstrates an investigation of Aerotech II and Parinebulizers for pulmonary delivery of pharmaceutical compositionscomprising paclitaxel and albumin.

The study was carried out using the paclitaxel-albumin pharmaceuticalcomposition ABI-007 under the following conditions: room temperature(20-23° C.), relative humidity (48-54%), ambient pressure (629 mmHg),nebulizer flowrate (10 L/min for Aerotech II; 7 L/min for Pari), totalflowrate (28.3 L/min), nebulizer pressure drop (23 lb/in² for AerotechII; 32 lb/in² for Pari), run time (15 to 60 seconds), sample volume (1.5mL), ABI-007 paclitaxel concentration (5, 10, 15 and 20 mg/mL).

Both Aerotech II and Pari nebulizers provided acceptable overallefficiency (30%-60%) when ABI-007 was reconstituted at a concentrationrange of 5-15 mg/mL. The Pari nebulizer efficiency had higher nebulizerefficiency than the Aerotech II nebulizer. The Pari nebulizer efficiencydecreased somewhat as ABI-007 concentration increased. Excellent fineparticle fraction was observed (74%-96%). The Aerotech II nebulizer hadhigher fine particle fraction than the Pari nebulizer. The fine particlefraction was independent of concentration.

The Pari nebulizer delivered 100 mg of paclitaxel in less than 30minutes using a 15 mg/mL solution of ABI-007. The Aerotech II nebulizerdelivered 100 mg of paclitaxel in about 65 min using either a 10 mg/mLor 15 mg/mL solution of ABI-007. Performance stability was tested forboth Aerotech II and Pari nebulizers. Aerosol concentration andefficiency of both nebulizers were stable until the drug was exhausted.At 15 mg/mL, the Pari nebulizer consumed the drug at twice the rate ofthe Aerotech II nebulizer and produced higher aerosol concentrationsthan that of the Aerotech II nebulizer.

In conclusion, the nanoparticle/albumin formulation of paclitaxel(ABI-007) shows excellent bioavailability in rats when administered bythe pulmonary route. There were no overt signs of early toxicity at theadministered dose. Pulmonary delivery of nanoparticle paclitaxel(ABI-007) may be achieved using conventional nebulizers.

EXAMPLE 34

This example describes intrapulmonary delivery of a pharmaceuticalcomposition comprising albumin and rapamycin. The purpose of this studywas to determine the pulmonary absorption of rapamycin in bloodfollowing intratracheal instillation to Sprague Dawley rats as comparedto intravenous installation.

The target volume of the intratracheal dose formulation that wasadministered to the animals was calculated based on a dose volume of 1mL per kg body. The intratracheal dosing apparatus consisted of aPenn-Century microsprayer (Model 1A-1B; Penn-Century, Inc.,Philadelphia, Pa.; purchased from DeLong Distributors, Long Branch,N.J.) attached to a 1 mL gas-tight, luer-lock syringe. The appropriatevolume of dose preparation was drawn into the dosing apparatus, thefilled apparatus was weighed and the weight-recorded. A catheter wasplaced in the trachea of the anesthetized animal, the microsprayerportion of the dosing apparatus was placed into the trachea through thecatheter, and the dose was administered. After dose administration theempty dosing apparatus was reweighed and the administered dose wascalculated as the difference in the weights of the dosing apparatusbefore and after dosing.

250 μL samples were collected from the indwelling jugular cannulas ofrats at the following predetermined post-dosing time points: 1, 5, 10,15, 30, and 45 minutes (min) and 1, 4, 8, and 24 hours (h). All bloodsamples analyzed were dispensed into pre-weighed sample tubes, and thesample tubes were reweighed, and the weight of each sample wascalculated by subtraction. The blood samples collected were assayed fortotal rapamycin concentration using LC/MS/MS.

Surprisingly, the results showed no significant difference in the bloodconcentration of rapamycin delivered via pulmonary route versusintravenously. The bioavailability of rapamycin delivered by thepulmonary route using a pharmaceutical composition comprising albuminwas calculated to be 109%, indicating excellent transport acrosspulmonary endothelium.

EXAMPLE 35

This example demonstrates tissue distribution of albumin-rapamycin afterintrapulmonary administration of a pharmaceutical composition comprisingrapamycin and albumin prepared in accordance with the present invention.The purpose of this study was to determine the pulmonary absorption ofrapamycin in tissue following intratracheal instillation to SpragueDawley rats as compared to intravenous installation.

The target volume of the intratracheal dose formulation that wasadministered to the animals was calculated based on a dose volume of 1mL per kg body. The dosing apparatus consisted of a Penn-Centurymicrosprayer (Model 1A-1B; Penn-Century, Inc., Philadelphia, Pa.;purchased from DeLong Distributors, Long Branch, N.J.) attached to a1-mL gas-tight, luer-lock syringe. The appropriate volume of dosepreparation was drawn into the dosing apparatus, the filled apparatuswas weighed and the weight-recorded. A catheter was placed in thetrachea of the anesthetized animal, the microsprayer portion of thedosing apparatus was placed into the trachea through the catheter, andthe dose was administered. After dose administration the empty dosingapparatus was reweighed and the administered dose was calculated as thedifference in the weights of the dosing apparatus before and afterdosing.

Samples were collected from the brain, lung, and, liver of three ratsper group per time point at 10 minutes, 45 minutes, 2 hours, and 24hours. The samples were collected and analyzed for total rapamycinconcentration using LC/MS/MS. The results indicate that rapamycinconcentration is greater in lung tissue when delivered via pulmonary ascompared to intravenous delivery. However, the total concentration ofrapamycin in the brain is lower when delivered via intratracheal (IT) ascompared to intravenous (IV). In the liver, there appears to be nodifference in the concentration of rapamycin whether delivered IT or IV.Based on these results, pulmonary delivery of rapamycin may be suitablefor the treatment of a condition (i.e., lung transplantation), whereinhigh local concentration of rapamycin would be beneficial.

EXAMPLE 36

This example demonstrates oral delivery of a pharmaceutical compositioncomprising paclitaxel and albumin (ABI-007).

Tritiated ABI-007 was utilized to determine oral bioavailability ofpaclitaxel following oral gavage in rats. Following overnight fasting, 5rats were given 5.5 mg/kg paclitaxel in ABI-007 (Group A) and another 5rats (Group B) were pretreated with cyclosporine (5.0 mg/kg) followed by5.6 mg/kg paclitaxel in ABI-007. A pharmacokinetic analysis of bloodsamples drawn at 0.5, 1, 2, 3, 4, 5, 6, 8, 12, and 24 hours wasperformed after determination of radioactivity in the blood samples bycombustion. Oral bioavailability was determined by comparison withintravenous data previously obtained. The results are set forth below inTable 5.

TABLE 5 Mean AUC 0-24, C_(max), T_(max) and % Absorption of³H-Paclitaxel Derived Radioactivity Following Oral AdministrationDose/Route AUC0-24 Absorption Cmax (mg/kg) Group Treatment mg/kg (μg eq× hr/mL) (%) (μg × eq/mL) Tmax (hr) A ABI-007 in Normal 5.5/PO(P) 2.9244.3 0.245 1 Saline B ABI-007 in 5/PO(C), 5.6/PO(P) 8.02 121.1 0.565 0.5Normal Saline with CsA

AUC 0-24 IV (6.06 μg×hr./mL) and IV dose (5.1 mg/kg) were used forcalculation of percent absorption (data based on IV dose of ABI-007).

An oral bioavailability of 44% was seen for ABI-007 alone. This isdramatically higher than is seen for other formulations of paclitaxel.The bioavailability increased to 121% when animals were treated withcyclosporine (CsA). This is expected as CsA is a known suppressor of thep-glycoprotein pump that would normally prevent absorption of compoundssuch as paclitaxel from the GI tract. The greater than 100%bioavailability can be explained by reabsorption following biliaryexcretion of paclitaxel into the GI tract. Other known suppressors orenhancers of absorption may be also utilized for this purpose.

EXAMPLE 37

This example demonstrates improved penetration of paclitaxel into redblood cells and tumor cells upon administration of a pharmaceuticalcomposition comprising paclitaxel and albumin.

Human MX-1 breast tumor fragments were implanted subcutaneously inathymic mice. A pharmaceutical composition comprising paclitaxel andalbumin (“paclitaxel-albumin”), as described previously, and Taxol wereprepared with ³H paclitaxel to a specific activity of 25 μCi/mgpaclitaxel. 20 mg/kg radiolabeled paclitaxel-albumin or Taxol wasadministered intravenously in saline when tumor volume reachedapproximately 500 mm³. Plasma, blood, and tumor tissue were sampled andanalyzed for radioactivity at 5, 15, and 30 minutes and at 1, 3, 8, and24 hours after administration. Tumor pharmacokinetic (AUC and absorptionconstant) was analyzed using WinNonlin, Pharsight, USA.

Paclitaxel-albumin exhibited rapid partitioning into red blood cells(RBCs) as shown by a rapid drop of the plasma/blood radioactivity ratioto unity after intravenous administration of the drug. Completepartitioning into RBCs occurred as early as 1 hr after administration ofpaclitaxel-albumin. In contrast, the partitioning of paclitaxelformulated as Taxol into RBCs was much slower and was not completeduntil more than 8 hrs.

Paclitaxel-albumin exhibited a rapid partitioning into tumor tissue withan absorption constant (K_(a)) that was 3.3× greater than Taxol. TheK_(a) were 0.43 hr⁻¹ and 0.13 hr⁻¹ for paclitaxel-albumin and Taxol,respectively. Rapid uptake of paclitaxel resulted in 33% higher tumorAUC for paclitaxel-albumin than for Taxol. The AUC were 3632 nCi*hr/gand 2739 nCi*hr/g for paclitaxel-albumin and Taxol, respectively.

EXAMPLE 38

This example demonstrates the safety of a pharmaceutical compositioncomprising paclitaxel and albumin administered to mice.

Athymic mice were treated with escalating doses of paclitaxel-albumin orTaxol everyday for 5 consecutive days. Survival was plotted versus doseto determine the LD₅₀. Survival was greatly improved withpaclitaxel-albumin versus Taxol (p=0.017, ANOVA). The LD₅₀ forpaclitaxel-albumin and Taxol were calculated to be 47 mg/kg/day and 30mg/kg/day for a q1d×5 schedule, respectively. At a dose level of 13.4mg/kg/day, both paclitaxel-albumin and Taxol were well tolerated withmortality of 1% (1 death out of 72 mice) and 4% (2 deaths out of 47mice), respectively. At a dose level of 20 mg/kg/day, there was 1%mortality for paclitaxel-albumin (1 death out of 72 mice) versus 17%mortality for Taxol (8 deaths out of 47 mice) (p=0.0025). At a doselevel of 30 mg/kg/day, there was 4% mortality for paclitaxel-albumin (3deaths out of 72 mice) versus 49% mortality for Taxol (23 deaths out of47 mice) (p<0.0001).

EXAMPLE 39

This example demonstrates a novel paclitaxel transport mechanism acrossmicrovessel endothelial cells (EC) for paclitaxel-albumin compositions.

Nanoparticles and albumin-paclitaxel compositions can accumulate intumor tissue due to EPR effect resulting from ‘leaky’ vessels in atumor. An albumin specific gp60 receptor (albondin) transported albuminacross EC by transcytosis of the receptors within caveolae at the cellsurface. This transcytosis mechanism allows for the transport ofalbumin-paclitaxel to the underlying interstitial space. In contrast,cremophor in Taxol inhibited binding of paclitaxel to albumin, greatlyreducing paclitaxel transport to the tumor. In addition, the gp16 andgp30 receptors also were involved in intracellular transport of modifiedalbumins containing bound paclitaxel, resulting in increased binding ofpaclitaxel to endothelial cells with a greater anti-angiogenic effect ascompared to Taxol.

EXAMPLE 40

This example demonstrates an increase in endothelial transcytosis ofpharmaceutical compositions comprising paclitaxel and albumin ascompared to Taxol.

Human lung microvessel endothelial cells (HLMVEC) were grown toconfluence on a transwell. The inventive pharmaceutical compositioncomprising paclitaxel and albumin, or Taxol containing fluorescentpaclitaxel (Flutax) at a concentration of 20 μg/mL, was added to theupper transwell chamber.

The transport of paclitaxel by transcytosis from the upper chamber tothe lower chamber was monitored continuously using a fluorometer. Acontrol containing only Flutax without albumin was also used. Thecontrol with Flutax showed no transport, validating the integrity of theconfluent HLMVEC monolayer. Transport of paclitaxel from thealbumin-paclitaxel composition was much faster than paclitaxel fromTaxol in the presence of 5% HSA (physiological concentration). Transportrate constants (K_(t)) for the albumin-paclitaxel composition and Taxolwere 1.396 hr⁻¹ and 0.03 hr⁻¹, respectively. The total amount ofpaclitaxel transported across the monolayer was three times higher forthe albumin-paclitaxel composition than Taxol.

EXAMPLE 41

This example demonstrates improved endothelial cell (EC) binding bypharmaceutical compositions comprising paclitaxel and albumin ascompared to Taxol.

Human umbilical vein endothelial cells (HUVEC) were grown on a 96-wellmicrotiter plate. In one experiment, paclitaxel (Flutax-Oregon Greenlabeled paclitaxel) was reacted with the HUVEC in the presence ofincreasing concentrations of Cremophor EL/EtOH, which is the vehicle forTaxol. In another experiment, a pharmaceutical composition comprisingalbumin and Flutax and a Taxol-Flutax composition were reacted to theHUVEC at various final concentrations. Binding of paclitaxel to cellswas inhibited by Cremophor. Inhibition was exhibited by an IC₅₀ of 0.02%of Cremophor EL/EtOH. This concentration of Cremophor has been shown topersist during Taxol chemotherapy for at least 24 hours. Therefore, itis a relevant process in vivo. At all concentrations tested, asignificant amount of paclitaxel from the albumin-paclitaxel compositionbecame bound to cells. In comparison, little or no binding was observedfor Taxol.

EXAMPLE 42

This example demonstrates improved albumin binding by pharmaceuticalcompositions comprising paclitaxel and albumin as compared to Taxol.

Human Serum Albumin (HSA) was immobilized on a plastic ELISA plate.Paclitaxel (Flutax-Oregon Green labeled paclitaxel) was reacted with theimmobilized HSA in presence of increasing concentrations of CremophorEL/EtOH. In another experiment, an albumin-paclitaxel-Flutax compositionand a Taxol-Flutax composition were reacted to immobilized HSA at afinal concentration of 20 μg paclitaxel/mL. Binding of paclitaxel toalbumin was inhibited by Cremophor. Inhibition was exhibited by an IC₅₀of 0.003% of Cremophor EL/EtOH. This concentration of Cremophor has beenshown to persist during Taxol chemotherapy for at least 24 hours.Therefore, it is a relevant process in vivo. At a relevant pharmacologicpaclitaxel concentration (20 μg/mL), a significant amount of paclitaxelfrom the albumin-paclitaxel composition became bound to immobilized HSA.In comparison, no binding was observed for Taxol.

EXAMPLE 43

This example demonstrates increased transfer of paclitaxel to albuminfor pharmaceutical compositions comprising paclitaxel and albumin ascompared to Taxol.

Taxol-Flutax and albumin-paclitaxel-Flutax compositions were mixed witheither 5% HSA in Hanks buffer or serum, at 20 μg/mL, 40 μg/ml, and 80μg/ml. The mixtures were immediately separated on a native 3-14%polyacrylamide gel and the amount of paclitaxel bound to albumin wasdetermined by a scanning fluorometer. The transfer of paclitaxel to HSAwas more rapid for the albumin-paclitaxel composition versus Taxol. Morepaclitaxel co-electrophoresed with HSA when either serum or 5% HSA wasincubated with the albumin-paclitaxel-Flutax composition or theTaxol-Flutax composition. Upon exposure to 5% HSA, 45%, 60%, and 33%more paclitaxel transferred to HSA for the albumin-paclitaxel-Flutaxcomposition than for the Taxol-Flutax composition, at 20 μg/ml, 40μg/ml, and 80 μg/ml, respectively. Upon exposure to human serum, 121%,31%, and 83% more paclitaxel transferred to HSA for thealbumin-paclitaxel-Flutax composition than for the Taxol-Flutaxcomposition, at 20 μg/ml, 40 μg/ml, and 80 μg/ml, respectively. The C.for ABI-007 at 260 mg/m² is approximately 20 μg/mL, therefore this is animportant process in vivo.

EXAMPLE 44

This example demonstrates that the glycoprotein receptor gp60 isresponsible for binding and transcytosis of albumin-paclitaxel.

Fluorescent labeled paclitaxel (Flutax) albumin compositions werecontacted with microvessel endothelial cells in culture. Fluorescentstaining was observed under a microscope with evidence of punctuateareas that were postulated to be the gp60 receptor binding thealbumin-paclitaxel. This was confirmed by using rhodamine labeledalbumin which colocalized with the punctuate fluorescence of paclitaxel.

EXAMPLE 45

This example demonstrates that increasing amounts of albumin can competewith binding of paclitaxel.

Albumin was immobilized on a microtiter plate. Fluorescent paclitaxelwas added into the wells and the binding of paclitaxel was measuredusing a scanning fluorometer. Increasing amounts of albumin were addedto the wells and the level of inhibiton of paclitaxel binding toimmobilized albumin was measured. The data showed that as the amount ofalbumin added was increased, a corresponding decrease in binding wasseen. A similar effect was seen with binding to endothelial cells. Thisindicated that higher albumin concentration inhibited binding ofpaclitaxel. Thus invention compositions having lower amounts of albuminare preferred.

EXAMPLE 46

This example demonstrates that lower amounts of albumin in the inventivepharmaceutical composition results in stable compositions.

To investigate if lower amounts of albumin in compositions would affectstability of the inventive pharmaceutical composition,albumin-paclitaxel compositions with low amounts of albumin wereprepared. It was found that these compositions were as stable ascompositions with higher quantities of albumin when examined for severalmonths at different temperatures (2-8° C., 25° C. and 40° C.) forpotency of paclitaxel, impurity formation, particle size, pH and othertypical parameters of stability. Thus compositions with lower amounts ofalbumin are preferred as this can greatly reduce cost as well as allowincreased binding and transport to cells.

EXAMPLE 47

This example demonstrates a pharmaceutical composition comprisingalbumin and paclitaxel having a high albumin to paclitaxel ratio.

30 mg of paclitaxel was dissolved in 3.0 ml methylene chloride. Thesolution was added to 27.0 ml of human serum albumin solution (3% w/v)(corresponding to a ratio of albumin to paclitaxel of 27). Deferoxaminewas added as necessary. The mixture was homogenized for 5 minutes at lowRPM (Vitris homogenizer, model Tempest I.Q.) in order to form a crudeemulsion, and then transferred into a high pressure homogenizer(Avestin). The emulsification was performed at 9000-40,000 psi whilerecycling the emulsion for at least 5 cycles. The resulting system wastransferred into a rotary evaporator, and methylene chloride was rapidlyremoved at 40° C., at reduced pressure (30 mm Hg) for 20-30 minutes. Theresulting dispersion was translucent, and the typical average diameterof the resulting paclitaxel particles was in the range 50-220 nm(Z-average, Malvern Zetasizer). The dispersion was further lyophilizedfor 48 hrs. The resulting cake was easily reconstituted to the originaldispersion by addition of sterile water or saline. The particle sizeafter reconstitution was the same as before lyophilization.

It should be recognized that the amounts, types and proportions of drug,solvents, proteins used in this example are not limiting in any way.When compared to toxicity of paclitaxel dissolved in cremophorformulations, the inventive pharmaceutical composition containingalbumin showed substantially lower toxicity.

EXAMPLE 48

This example demonstrates a pharmaceutical composition comprisingalbumin and paclitaxel having a low albumin to paclitaxel ratio.

Specifically, 300 mg of paclitaxel was dissolved in 3.0 ml methylenechloride. The solution was added to 27 ml of human serum albuminsolution (5% w/v). (corresponding to a ratio of albumin to paclitaxel of4.5). Deferoxamine was added as necessary. The mixture was homogenizedfor 5 minutes at low RPM (Vitris homogenizer, model Tempest I.Q.) inorder to form a crude emulsion, and then transferred into a highpressure homogenizer (Avestin). The emulsification was performed at9000-40,000 psi while recycling the emulsion for at least 5 cycles. Theresulting system was transferred into a rotary evaporator, and methylenechloride was rapidly removed at 40° C., at reduced pressure (30 mm Hg)for 20-30 minutes. The resulting dispersion was translucent, and thetypical average diameter of the resulting paclitaxel particles was inthe range 50-220 nm (Z-average, Malvern Zetasizer). The dispersion wasfurther lyophilized for 48 hrs. The resulting cake was easilyreconstituted to the original dispersion by addition of sterile water orsaline. The particle size after reconstitution was the same as beforelyophilization.

It should be recognized that the amounts, types and proportions of drug,solvents, proteins used in this example are not limiting in any way.When compared to toxicity of paclitaxel dissolved in cremophorformulations, the inventive pharmaceutical composition containingalbumin showed substantially lower toxicity.

EXAMPLE 49

This example demonstrates a pharmaceutical composition comprisingalbumin and paclitaxel having an intermediate albumin to paclitaxelratio.

Specifically, 135 mg of paclitaxel was dissolved in 3.0 ml methylenechloride. The solution was added to 27 ml of human serum albuminsolution (5% w/v). Deferoxamine was added as necessary. The mixture washomogenized for 5 minutes at low RPM (Vitris homogenizer, model TempestI.Q.) in order to form a crude emulsion, and then transferred into ahigh pressure homogenizer (Avestin). The emulsification was performed at9000-40,000 psi while recycling the emulsion for at least 5 cycles. Theresulting system was transferred into a rotary evaporator, and methylenechloride was rapidly removed at 40° C., at reduced pressure (30 mm Hg)for 20-30 minutes. The resulting dispersion was translucent, and thetypical average diameter of the resulting paclitaxel particles was inthe range 50-220 nm (Z-average, Malvern Zetasizer). The dispersion wasfurther lyophilized for 48 hrs. The resulting cake was easilyreconstituted to the original dispersion by addition of sterile water orsaline. The particle size after reconstitution was the same as beforelyophilization. The calculated ratio (w/w) of albumin to paclitaxel inthis invention composition is approximately 10.

It should be recognized that the amounts, types and proportions of drug,solvents, proteins used in this example are not limiting in any way.When compared to toxicity of paclitaxel dissolved in cremophorformulations, the inventive pharmaceutical composition containingalbumin showed substantially lower toxicity.

EXAMPLE 50

This example demonstrates the treatment of rheumatoid arthritis in ananimal model with an albumin-paclitaxel composition.

The collagen induced arthritis model in the Louvain rat was used to testthe therapeutic effect of albumin-paclitaxel composition on arthritis.The paw sizes of the experimental animals were monitored to evaluate theseriousness of arthritis.

After the arthritis was fully developed (usually ˜9-10 days aftercollagen injection), the experimental animals were divided intodifferent groups to receive either albumin-paclitaxel 1 mg/kg q.o.d, oralbumin-paclitaxel 0.5 mg/kg+prednisone 0.2 mg/kg q.o.d. (combinationtreatment) intraperitoneally for 6 doses, then one dose per week forthree weeks. The paw sizes were measured at the beginning of treatment(day 0) and every time the drug was injected. One group received onlynormal saline as control. By the end of the experiment, the groupreceiving albumin-paclitaxel achieved a 42% reduction of paw size, thecombination treatment group showed a 33% reduction of the paw size,while the control group had about 20% increase of the paw size relativeto the time when the treatment was initiated.

In conclusion, the albumin-paclitaxel compositions demonstratedtherapeutic effect on arthritis. The albumin-paclitaxel combinations arelikely to localize at sites of arthritic lesions by transport throughreceptor-mediated mechanisms like gp60.

EXAMPLE 51

This example demonstrates the use of albumin-paclitaxel compositions totreat cardiovascular restenosis.

Paclitaxel eluting stents in animals cause incomplete healing and, insome instances, a lack of sustained suppression of neointimal growth inthe arteries. The present study tested the efficacy of a novel systemicdelivery albumin-paclitaxel invention compositions for reducing in-stentrestenosis.

Saline-reconstituted albumin-paclitaxel was tested in 38 New ZealandWhite rabbits receiving bilateral iliac artery stents. Doses ofalbumin-paclitaxel (1.0 to 5.0 mg/kg paclitaxel dose) were administeredas a 10-minute intra-arterial infusion; control animals received vehicle(0.9% normal saline).

In a follow-up chronic experiment, albumin-paclitaxel 5.0 mg/kg wasgiven at stenting with or without an intravenous 3.5-mg/kgrepeatalbumin-paclitaxel dose at 28 days; these studies were terminatedat 3 months. At 28 days, mean neointimal thickness was reduced (p<=0.02)by doses of albumin-paclitaxel >=2.5 mg/kg with evidence of delayedhealing. The efficacy of a single dose of albumin-paclitaxel 5.0 mg/kg,however, was lost by 90 days. In contrast, a second repeat dose ofalbumin-paclitaxel 3.5 mg/kg given 28 days after stenting resulted insustained suppression of neointimal thickness at 90 days (p<=0.009versus single dose albumin-paclitaxel 5.0 mg/kg and controls) withnearly complete neointimal healing.

Although systemic albumin-paclitaxel reduces neointimal growth at 28days, a single repeat dose was required for sustained neointimalsuppression. Thus, the inventive composition is suitable for treatmentof cardiovascular diseases such as restenosis. Inventive compositionscomprising pharmaceutical agents other than paclitaxel, for examplerapamycin, other taxanes, epothilones etc, are all suitable fortreatment of restenosis in blood vessels or artificial blood vesselgrafts such as those used for arterio-venous access in patientsrequiring hemodialysis.

What is claimed is:
 1. A method of treating cancer in a humanindividual, comprising injecting into the individual an effective amountof a pharmaceutical composition comprising paclitaxel and apharmaceutically acceptable carrier, wherein the pharmaceuticallyacceptable carrier comprises albumin, wherein the albumin and thepaclitaxel in the composition are formulated as particles, wherein theparticles in the composition have a particle size of less than about 200nm, and wherein the weight ratio of albumin to paclitaxel in thecomposition is about 1:1 to about 9:1, wherein the cancer is a cancer ofthe esophagus, stomach, small intestine, colon, or rectum.
 2. The methodof claim 1, wherein the albumin is human serum albumin.
 3. The method ofclaim 1, wherein the ratio (w/w) of the albumin to the paclitaxel in thepharmaceutical composition is 1:1 to 9:1.
 4. The method of claim 1,wherein the ratio (w/w) of the albumin to the paclitaxel in thepharmaceutical composition is about 9:1.
 5. The method of claim 2,wherein the ratio (w/w) of the albumin to the paclitaxel in thepharmaceutical composition is 1:1 to 9:1.
 6. The method of claim 2,wherein the ratio (w/w) of the albumin to the paclitaxel in thepharmaceutical composition is about 9:1.
 7. The method of claim 1,wherein the pharmaceutical composition is injected intravenously.
 8. Themethod of claim 2, wherein the pharmaceutical composition is injectedintravenously.
 9. The method of claim 3, wherein the pharmaceuticalcomposition is injected intravenously.
 10. The method of claim 4,wherein the pharmaceutical composition is injected intravenously. 11.The method of claim 5, wherein the pharmaceutical composition isinjected intravenously.
 12. The method of claim 6, wherein thepharmaceutical composition is injected intravenously.